iL& INI THE GIFT OF le /man C 41n 0 MMWEEERNRTW M R tz(, S-5 N.5 Z 3 'D 3Lýt EARLY DAYS OF THE PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK JAMES LENOX, LL.D. EARLY DAYS OF THE PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK BY DAVID BRYSON DELAVAN, M. D. Consultant: St. Luke's, Memorial, Ruptured and Crippled Hospitals President: Russell Sage Institute of Pathology, Grenfell Association of America Trustee: New York Dispensary Formerly Resident House Officer Presbyterian Hospital WITH 34 FULL PAGE ILLUSTRATIONS PUBLISHED PRIVATELY 1926 PRINTED BY THE ABBEY PRINTSHOP, Inc. EAST ORANGE, N. J. COPYRIGIIT, 1926 BY D. BRYSON DELAVAN, M:D. TO THE PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK FOUNDED BY JAMES LENOX WITH REVERENT MEMORIES OF ITS PAST APPRECIATION OF ITS PRESENT AND STEADFAST HOPE FOR ITS FUTURE FOREWORD This attempt to rescue from oblivion the story of the founding of a great institution is made as a tribute to the memory of men through whom we, their followers, have enjoyed unusual benefits; and as a reminder of altruistic efforts by which our present advantages have been secured. In it I have tried to present a series of pictures of men and things as they came under my personal knowledge and observation. It was my fortune to have been associated from childhood with several of the founders of the Presbyterian Hospital, as well as with various members of its Medical Board. The incidents attending its inner history, from its inception, were frequently discussed in my presence. As Resident House Officer at a period when its affairs were undergoing important readjustment, and thereafter, abundant opportunities were offered for acquaintance with its managers, its physicians and its career. My active association with the Hospital, although short, was one of the invaluable experiences of a lifetime. It conferred an obligation gratefully here acknowledged, in the only way now possible. Those good men of fifty years ago with whom my story deals were kind and helpful friends to me. Many of their ideas and methods, while apparently crude in the light of present day science, were in fact advanced and in many instances well calculated to prepare the way for the improvements which have followed; while the strength of their fine intelligence remains unchallenged and the beauty of their characters and the generous breadth of their humanity glowv with ever increasing brightness. With the passage of time and the loss of records the memory of those concerned in the founding of the hospital and the circumstances attending its early history have well nigh faded into obscurity. To the present generation even Mr. Lenox himself is practically unknown. Few are left from whom definite information can be gained. But if the story of the heredity and birth of a distinguished man, a great nation, or a highly successful enterprise of any kind is worthy of note, the early history of the Presbyterian Hospital should be of ever increasing value. The fine spirit which actuated its founders and the lofty and advanced ideas which they so bravely strove to carry out are priceless traditions, replete with inspiration and enlightenment. Of these traditions we cannot be too proud. They should be zealously guarded, sacredly preserved; whatever else of change the years may bring they should never cease to be its guiding, uplifting sentiment. As originally conceived, the Hospital was a great benevolent enterprise, undertaken by men of singularly pure motive, clear vision and generous impulse, led by the most remarkable philanthropist of his time. The Board of Managers, as well as the Medical Board of the Presbyterian Hospital contained men of distinction in their various departments, some knowledge of whom is essential. It will be our aim to offer a brief record of the circumstances which led to the founding of the Hospital, to recall some of those who were its early sponsors and to relate as far as memory may permit, the conditions under which it flourished during the first years of its active life. For the suggestion of placing the material of the book in permanent form we are indebted to Miss Mabel Davies, formerly Assistant Superintendent of the Presbyterian, now Superintendent of the Beekman Street Hospital; while in the execution of the work, aid has been given with cheerful alacrity by Miss Helen Young, Directress of Nursing, and from every quarter of the Hospital group. The illustrations have been secured from the collections of the Hospital, the New York Academy of Medicine, the New York Public Library and my own. A list of publications, of interest in connection with our subject, is given in the Appendix. D. B. D. 10 CONTENTS Dedication................................. 7 Forew ord........................... 9 List of Illustrations................................ 13 The Origin and Birth of the Hospital................ 17 James Lenox...................................... 31 Robert Lenox...................................... 31 The Lenox Library............................... 37 The Early Days of the Hospital.................... 47 The Original Buildings............................. 51 The T ablet........................................ 57 The First Medical Board........................... 61 The Resident Directress............................ 65 The Farewell Letter of Miss Jane Stuart Woolsey.... 68 Reorganization and Reminiscences.................. 75 Environment and More Reminiscences............... 81 Contrasts.................................... 87 Surgery, 1872-1876................................. 95 Nursing, and the Development of the Training School. 103 Anna Caroline Maxwell.......................... 113 Jane Stuart Woolsey and Sisters.................... 119 Great Men of the Presbyterian Hospital.............. 127 Oliver W hite..................................... 131 Willard Parker..................................... 135 Alonzo Clark....................................... 141 Jared Linsly....................................... 145 Gurdon Buck..................................... 149 William Holmes VanBuren......................... 155 William Ludwig Detmold.......................... 159 Alfred Charles Post................................ 163 Charles Kelly Briddon.............................. 167 Lewis Atterbury Stimson........................... 171 Samuel Thomas Hubbard........................... 177 George Jacob Peters................................ 181 John Jacob Crane.................................. 182 Thomas E. Satterthwaite........................... 185 The Future..................................... 187 Appendix........................................ 190 11 LIST OF ILLUSTATIONS James Lenox................................... 4 The Hospital as completed in 1872................. 16 Robert L. Stuart................................ 28 Residence of James Lenox......................... 30 Robert Lenox................................... 32 The Lenox Library............................. 36 Full Plan of the Hospital (Elevation).............. 46 Ground Plan of the Hospital........................ 50 The Tablet..................................... 56 Nelson Buell Sizer................................. 60 Jane Stuart Woolsey......................... 64 David Bryson Delavan........................... 74 Squatter Settlement................................ 80 C. Irving Fisher................................ 88 Pasteur- Lister................................... 94 Wm. Gilman Thompson......................... 102 John S. Kennedy............................. 108 The Presbyterian Hospital, 1896..................... 110 Anna Caroline Maxwell........................... 112 Jane Stuart Woolsey................................ 118 Olver W hite.................................... 130 Willard Parker.................................. 134 Alonzo Clark.................................... 140 Jared Linsly................................. 144 Gurdon Buck................................... 148 William Holmes VanBuren...................... 154 William Ludwig Detmold....................... 158 Alfred Charles Post............................. 162 Charles Kelly Briddon........................... 166 Lewis Atterbury Stimson......................... 170 Samuel Thomas Hubbard.........................176 George Absalom Peters.......................... 180 Thomas E. Satterthwaite...................... 184 The New Hospital................................ 189 13 THE ORIGIN AND BIRTH OF THE PRESBYTERIAN HOSPITAL THE PRESBYTERIAN HOSPITAL 1872 THE ORIGIN AND BIRTH OF THE PRESBYTERIAN HOSPITAL Of the many changes which the present period is witnessing, none are more impressive than those connected with the science of medicine. Foremost among the pioneers in its onward march, the Presbyterian Hospital is leading the way. For many years it has been quietly but steadily advancing in influence and prestige. T'oday it stands in the front rank of progressive medical institutions. The possibilities of its future development and usefulness are unlimited. Sixty years ago its sole existence was encompassed within the heart and mind of one generous, far seeing man. Mr. James Lenox, a public spirited citizen of well recognized eminence, had long considered the establishing of a great hospital. Gradually his ideas had taken form and in 1868 had become sufficiently definite to be announced and put in execution. The initial history of this period of the Presbyterian Hospital was elaborately set forh in the early volumes of its Annual Reports, the first of which appeared in 1869. In this and in the succeeding numbers careful record was made of the proceedings of the Board of Managers and of the current affairs of the institution. Somewhat extensive expositions were also entered into as to the ideas and the intentions of the founders, their present aims and their hopeful expectations of the future growth and usefulness of their new undertaking. Few copies of these early Annual Reports are now in existence. This is unfortunate, for the matter which they contain is eminently worthy of preservation. Not only does it give a complete series of facts of prime historical importance but it is also most interesting as affording enlightening glimpses of the moral atmosphere of the time. As explained by Mr. Lenox, the Presbyterian Hospital originated in the ascertained necessity for enlarged hospital accommodations to meet the wants of the sick and disabled of the rapidly augmenting population of the city. He believed that the success of such an undertaking would be promoted by giving it in some, degree a denominational character. 17 In the first annual report there is given a full statement of the primary organization of the Hospital, in which it is pertinently stated that "it seemed appropriate to notice the incipient and successive measures -Awhich were taken in this philanthropic enterprise." Thus from the beginning, the great possibilities of the future were recognized. The question of the suggested Hospital having been discussed, a circular letter was addressed to such gentlemen in the City as might sympathize in its objects: SNew York, Jan. 2, 1868. Sir: The City of New York has many General Hospitals, as well as others appropriated to specific purposes; it also contains several under the control of nationalities and religious denominations. Among the latter, the Jewish, the German and St. Luke's (Episcopal) may be named. But the large and influential body of Presbyterians has no such institution of this kind under its care. Its members have been very liberal in assisting almost all the Associations alluded to, and have taken part in the management of many of them, but they have not, as yet, imitated other churches by sustaining a hospital of their own. It is to supply this want that application is now made to you among the other gentlemen whose names are enumerated in one of the accompanying papers and with whomn you are invited to join as a manager in establishing a Presbyterian Hospital in this city. You will find enclosed drafts of an Act of Incorporation, and of a Constitution, under which such an institution might be formed. These are intended merely as specimens of what may be desirable. As soon as those to whom this paper is addressed have signified their willingness to act as Managers of the Hospital a meeting will be called at which the enclosed papers may be added to, or modified, and measures adopted to apply to the Legislature for incorporation. It may be well to state in this connection that no powers or privileges have been asked for, or intended to be exercised, which have not been granted to one or more of the hospitals now in operation in this city. Should such an Act be obtained, or one essentially similar in its provisions, I am authorized to say a large and eligibly situated plot of ground in this city suit18 able for buildings, and funds to the amount of one hundred thousand dollars, to be appropriated either toward the erection of such buildings or some other purposes connected with the establishment and maintenance of a hospital, will be made over to the managers as soon as practicable. May I respectfully ask that you will inform me, at as early a date as possible, whether you will allow your name to be used as one of the Managers of the Presbyterian Hospital? I remain, Sir, yours very truly, JAMES LENOX. This letter, with its munificent proposals, received encouraging replies. On the 30th day of January following, a meeting was called at which a full attendance was secured and a temporary organization effected by the appointment of a Board of Managers consisting of 32 members, from among the most influential men of the city, as follows: JAMES BROWN THOMAS C. M. PATON MARSHALL S. BIDWELL JOSEPH STUART AARON B. BELKNAP ROBERT L. STUART WILLIAM E. DODGE THOMAS M. SMITH JAMES DONALDSON JONATHAN STURGES JOHN C. GREEN OTIS D. SWAN WINTHROP S. GILMAN CHARLES N. TALBOT ROBERT M. HARTLEY WILLARD PARKER, M. D. RICHARD IRVIN JOHN R. FORD EDWARD S. JAFFRAY HENRY M. TABER THOMAS JEREMIAH ALEXANDER VAN RENSSELAER MORRIS K. JESUP WILLIAM M. VERMILYE JOHN TAYLOR JOHNSTON WASHINGTON R. VERMILYE JAMES LENOX APPOLLOS R. WETMORE DAVID OLYPHANT A. ROBERTSON WALSH WILLIAM PATON GEORGE DE FOREST LORD HENRY PARISH An Act of Incorporation to found "a Presbyterian Hospital in the City of New York" was passed by the Legislature February 28th. On the 26th day of March following the Charter was considered and accepted by the Board of Managers and the following officers were elected: JAMES LENOX, President JOHN C. GREEN, Vice-President AARON B. BELKNAP, Treasurer ROBERT M. HARTLEY, Corresponding Secretary HENRY M. TABER, Recording Secretary A permanent legal status having thus been secured, at a subsequent meeting held June 17th, the President con-- 19 veyed in due form to the Board of Managers, for hospital uses, the block of ground in the City of New York bounded by Seventieth and Seventy-first Streets and Fourth and Madison Avenues, and with it the sum of one hundred thousand dollars, both tax free. The whole matter was instituted and inspired by Mr. Lenox. The value of the property donated by him was at that time, 1868, about two hundred and fifty thousand dollars. His subsequent gifts to the Hospital aggregated an equal amount. Next to Mr. Lenox, the largest donors were the brothers Robert L. and Alexander Stuart, men of ample means but of still broader generosity and public spirit. Among the foremost in various great enterprises, both financial and philanthropic, Mr. Robert L. Stuart was for many years President of the American Mluseum of Natural History. Messrs. James Brown, John C. Green and Joseph Sampson became "Patrons" of the Hospital from having subscribed ten thousand dollars or more. The work of constructing an edifice of high order, embracing all modern improvements in hospital architecture, was given extensive consideration. Recent developments in medical science and hospital hygiene had greatly modified former theories. It was determined "to embody in the plan of the structure and its arrangements whatever had been discovered that could be applied for the alleviation of suffering and the restoration of health." In support of the idea of the new hospital a number of conditions calling for the existence of such an institution were mentioned, and arguments advanced. Attention was directed to the growth of Dispensaries in New York City, the number of them already having equalled twelve. Hospital facilities were less adequate, especially for the benefit of the resident native population. Of the six hospital institutions not under control of the State, nameyv the New York, St. Luke's, St. Vincent's, St. Franciscus, mIt. Sinai and the German Hospital-besides a few other smnialler ones for the treatment of special diseases-but one, the New York H-ospital, the oldest and most respected of its class, was of a general metropolitan character. The remaining five were denominational in origin and policy, and, excepting St. Luke's, patronized and controlled by citizens of foreign nationalities. When the Presbyterian Hospital was established there would be but three of a popular American character for the entire city of nearly one million-souls. 20 Emphasis was placed upon the necessity for hospital care and hygiene for the benefit of respectable workers at small salaries, both men and women, often lodging in cheap, comfortless, unhealthy boarding houses, without care and attention, as well as "for every proper applicant whom Providence might send to us, many of them strangers and even members of our churches." These, when in need, had no resources but to accept pauper relief at Bellevue, or to suffer uncared for at home. Again, the maritime position of the city, its vast commercial, manufacturing and business activities, its overcrowded thoroughfares, the density of the population, the immense influx and egress of strangers, with the consequent casualties and sudden sicknesses inseparable from these conditions, now very numerous, increasing with the growth of the city, would ever require proportional hospital arrangements. "Let the necessity for such a hospital be fully understood by our citizens, their known liberality justifies the belief that one which so strongly appeals to their justice, their piety and humanity, will commend itself to their favor. Whatever may be thought of other forms of charity, there can be but one opinion in regard to this. In such charity our ability is the measure of our duty. The dictates of Revelation, not less than the moral law of our Constitution, demands this at our hands. "Such, imperfectly, are its claims. Yes, more than this. It is full of promise for the future. It is the sowing of perennial seed, with the certainty of a long succession of harvests. "In whatever aspect it is viewed it strongly commends itself to approval and support. No other benevolent effort is more needed in this city, nor is there one more likely to confer great and lasting benefits on suffering humanity." In conclusion it was remarked that the enterprise embraced the Old and New School Presbyterian Churches; the Reformed Dutch and the Reformed Presbyterian Churches; all the Churches, indeed, in the city that acknowledged Presbyterian policy and doctrine. Probably no appeal on so broad a basis as respected unity of faith, irrespective of minor differences, had ever before been presented to the churches of this order in this city. This inspired the hope and trust that there would be a like union of spirit and effort for this pre-eminently Christian undertaking, in which all had a common interest. 21 The Board of Managers having responded liberally to the call for funds, an appeal was made to the general public and in particular to the P esbyterian Churches, through a series of statements, calling attention to the necessity and importance of the work, of which the following is a summiary: I. The proposed Institution is needed to properly care for the sick of the rapidly increasing population of our city. The situation of the capacious block which has been conveyed to the Trustees is most desirable, being in one of the most elevated parts of the island, and easily accessible by the city railroads. II. It is needed for the benefit of a large Christian denomination to awaken a new interest in Hospital labors. The time has come when a greater devotion to this Christlike work is demanded of our Church. The establishment of St. Luke's Hospital and other kindred institutions has reacted with power on the spiritual interests of those connected with them. We may reasonably expect that the establishment of the Presbyterian Hospital will be likewise an effective means of increasing the activity of Presbyterians in this line of duty. The benefit of this work to the Church is two-fold: First. In promoting the spiritual growth and prosperity of Christians. The Hospital affords the field for that kind of service which quickens the sympathies and prayers, and gives exercise to the active energies of church members. Second. In promoting the spirit of union among the various branches of one Body, by bringing their members together to labor in a common cause. Much of this spirit, which is now happily uniting believers, is justly attributed to the co-operation of Christians of various denominations in hospital duty during the late war. III. Each body of Christians should possess a place of refuge where their own sick and suffering members are especially provided for. In the light of this obligation the name "Presbyterian," which to some may have appeared narrow, is seen to have a peculiar significance. Although the Hospital is under Presbyterian auspices, it is by no means designed to be exclusive; the very comprehensiveness of the plan would prevent this. As long as there is room, its doors will be open to every one who may need its 22 aid, under the restrictions which are common to all hospitals. IV. The permanency of the Hospital is one great element of its importance. It was a favorite remark of the late Dr. James W. Alexander, that the establishment of a Christian Church was especially important because of the permanency of its benefits in the community. The same remark applies with equal propriety to the Christian Hospital. Ordinary societies may change and the benefits designed by founders may not be realized, but he who aids in the foundation of a hospital to be cared for perpetually by Christians helps in that which is to bless the poor and needy for generations after the giver has gone to his reward. V. The increasing interest in the subject is an important sign of the times. It is an interesting fact that the first patient who underwent what could properly be called an operation, in the Massachusetts General Hospital, was a Mr. Goodnow, whose mind was thereby so impressed with the great benefit of the Institution to the poor, that long thereafter he bequeathed his estate to aid in the establishment of the Boston City Hospital. That Institution, with its extensive appointments, and the Rhode Island Hospital, also lately opened in Providence, to which the citizens there have contributed nearly half a million of dollars for construction and endowment, bear witness to the increasing sense of the importance of this work. According to the highest medical authority, the general construction of Iospitals up to the year 1860 had been faulty. Many constructed since that date are deemed defective. Enjoying the benefits of the experience of those who were in the field before us, the Managers of the Presbyterian Hospital of New York hope to make the funds given to this enterprise accomplish the greatest amount of good. The highest usefulness of the institution can be attained only by enlarging to the greatest extent the number of its contributors and friends. This opportunity is of peculiar interest to us as Presbyterians. The providence of God points us to the work, our spiritual interests call on us to engage in it, and at this very juncture the! basis for action is most invitingly laid open to us by the large donations alluded to in the Report. 23 VI. The opportunity appeals likewise to all, irrespective of religious preferences. The establishment of Hospitals has always possessed peculiar interest to men of enlarged views and philanthropic feelings. Those who are unconnected with any Christian denomination have frequently been large contributors. It has been their choice to place the Hospital under Christian influences. A most important truth is now permeating society like leaven, viz: That they only derive the full benefit of their property who use the gift during their lifetime for the benefit of others. It has been most eloquently expressed by a distinguished jurist, as follows: "They who merely accumulate or preserve wealth, are its servants; those who expend it upon themselves, become its victims; those only who use it grandly are its masters." You are respectfully solicited to send a donation for this object to A. B. Belknap, Treasurer, No. 20 Exchange Place, New York, or to consult with any of the Managers, who will be happy to afford you every information. The organization of the hospital having been completed, the general principles of action determined upon, the site donated and the necessary funds assured, the Board with commendable promptness began its work. Frequent meetings were held, plans submitted and approved, a Medical Staff organized, the buildings finished and equipped and proper service installed. Upon October 10, 1872, the New Hospital was formally opened. The services were held in the Chapel, in the presence of a large audience of distinguished and devoted friends. The ceremonies attendant upon the inauguration were dignified and impressive, as befitted an event of unusual importance, for the Hospital had been planned with rare broad-mindedness and the expenses of its creation met with unstinted liberality. The most experienced aid, both medical and lay, had been sought in its development. Its buildings were the work of a distinguished architect, its equipment and service the best obtainable. In the light of the then existing conditions a high degree of perfection had been attempted and attained. A model institution had been created, one ideally, as well as ma24 terially, in advance of those which had gone before. It was natural that its opening should be greeted with acclaim Much was expected of it. In his presidential address Mr. Lenox explained the intentions and hopes of the founders of the Hospital and set forth the fundamental principles upon which they were based. Declining the use of his own name, he introduced the institution to the world as "THE PRESBYTERIAN HOSPITAL, PRESBYTERIAN IN ITS BURDENS BECAUSE FOUNDED BY PRESBYTERIANS; UNDENOMINATIONAL IN ITS BENEFITS BECAUSE FOR THE RECEPTION OF PATIENTS IRRESPECTIVE OF CREED, NATIONALITY OR COLOR. The impressiveness of this declaration and the splendid dignity with which it was delivered have remained a vivid recollection to me. 25 ROBERT L. STUART ROBERT L. STUART JAMES LENOX RESIDENCE OF JAMES LENOX CORNER FIFTH AVENUE AND TWELFTH STREET JAMES LENOX As the Hospital owed its existence to Mr. Lenox, nothing could better illuminate the story of its birth than a study of the character and the career of that remarkable man. James Lenox, A.B., A.M., LL.D., was born in the City of New York on August 19, 1800. He was the only son of MAr. Robert Lenox and of his wife Rachel, daughter of Nicholas Carmer, a descendant of one of the earliest Dutch settlers of.N.ew Amsterdam. Robert Lenox with several brothers had come to this country about the time of the Revolutionary war, from Kirkcudbright, Scotland, the birthplace, by the way, of Admiral John Paul Jones. All of the brothers succeeded in gaining an excellent standing in the land of their adoption and became men of more or less prominence. The most successful of them was Robert, who, as a commission merchant, soon attained a leading position, trading extensively abroad, in the West Indies and in this country..His business transactions for many years surpassed in importance and extent those of any other merchant in New York City at that period. He not only amassed a large fortune but established himself as one of New York's most influential citizens in no ordinary sense. During the active part of his career he held several of the highest positions of trust that the City afforded; thus, he was President of the Chamber of Commerce; a member, like my own grandfather, of the Board of Aldermen at a time when a place upon the City Council was held in very different esteem from at the present day; one of the founders of the New York Lying-in-Hospital and for some time President of its Board; a member of that highly exclusive organization, the Board of Governors of the Sailors' Snug Harbor; and a Trustee of Princeton College. The remarkable variety of the above appointments would indicate that Mr. Robert Lenox was a man of unusually broad attainment, great executive ability and highly intelligent philanthropy. He died in 1839, at the age of eighty years. In August, 1794, one hundred and thirty years ago, New York City was visited by an epidemic of yellow fever. Governor DeWitt Clinton appointed a committee of fifteen prominent citizens with full power to act. Of this com31 ~: ~ " " ~:?:.::! mittee the late Dr. Samuel Bard and Mr. Robert Lenox were members, Mr. Lenox being its Secretary. At the suggestion of Dr. Bard, it was recommended that a certain house and plot of land, lying upon the shore of the East River and known as "Bellevue," belonging to the Murray Estate, be purchased and placed in the hands of the committee, for the care of the sick. The business part of this transaction was committed to Mr. Lenox. The outcome of his labor, finally consummated by the genius of Dr. John Winters Brannan, is the Bellevue Hospital of today. It is stated that when Mr. Lenox was an executor of the Estate of his friend, Mr. Archibald Gracie, a mortgage held by the estate was foreclosed and, in order that the estate might not lose the amount invested, of which there was some likelihood, and to net the beneficiaries an exceptional sum, he purchased the mortgaged premises at public auction held in the old Tontine Coffee House, for what was then the remarkable sum of $6,420 the land being considered worth only $500. The premises were known as the "Five Mile Post Farm" and comprised land within the boundaries of Fourth and Fifth Avenues and 68th and 71st Streets. Four months later Mr. Lenox purchased three parcels of land bounded by Fourth and Fifth Avenues and 71st and 74th Streets, exactly equal in area with the parcels purchased under foreclosure at public auction. The price paid for this second plot was $500. Thereafter these two tracts were known as "The Lenox Farm." The Old Farm House was on what is now 71st Street, near Fifth Avenue, about five miles from City Hall. Mr. Robert Lenox never sold any of the land in his lifetime and had a high opinion of its value. In his will, referring to this plot and to his son, James Lenox, he devised it "to James' heirs forever. My motive for so leaving this property is a firm persuasion that it may at no distant date be the site of a village, and as it cost me more than its present worth, from circumstances known to my family, I will cherish that belief that it may be realized by them. At all events I want the experiment made by keeping the property from being sold." Later the above was modified as follows: "At the same time I wish him, my son, to understand that my opinion of tle property is not changed and although I withdraw all legal restrictions to his making sale of the whole or any part of the same, yet I enforce on him my advice not to do so." 33 The records of the Chamber of Commerce say of Mr. Robert Lenox, "he was one of the most extensive as well as successful merchants in the United States; an eminent citizen wAho for a period beyond the ordinary course of human life was distinguished for great prudence, clear and sound judgment and unblemished reputation." Of such ancestry and with such direct example of excellence to guide and inspire him, it is natural that the career of Robert Lenox's only son should have been one of unusual distinction. With the subsequent growth of the city Mr. James Lenox had before him the example of several large holders of unimproved real estate whose policy was to allow their neighbors to make the improvements which should enhance the value of their own property. MTr. Lenox realized that such selfish action was not in the interest of the public or even of the owner himself. By selling parcels to selected buyers he could in a measure influence the ultimate character of the whole, thus protecting the region from undesirable control. The wisdom of his foresight is proved in the present high order of occupancy of Lenox Hill. Mr. James Lenox held the land until 1864, when he commenced to convey various lots in the tract and at his death in 1880 sales of portions of it had netted him over three million dollars and the value of the remainder which included the tracts he had given the Presbyterian Hospital, the Phillips Presbyterian Church, the Home for Aged Women and the Lenox Library was over four million dollars. On an investment of about seven thousand dollars this meant an increase of seven million dollars in a little over sixty years and at the present time a conservative appraisal of the Lenox Farm would be between fifty and sixty million dollars. Needless to say, James received an excellent early education. He graduated from Columbia College in 1818 and in 1821 received from Princeton College the degree of A.M. He then studied law and was admitted to the Bar, afterwards going to Europe for several years for purposes of study and travel. He returned to New York in 1826 and joined his father in business, the firm becoming Robert Lenox and Son, at 59 Broadway. Shortly after his father's death in 1839 the firm name was changed to James Lenox, Merchant, and so continued until about 1845 when Mr. Lenox retired from business and devoted himself to the pursuits most congenial to him, making his headquarters at 34 his residence, No. 53 Fifth Avenue, at the North East corner of Twelfth Street, adjoining the home of his sister, Miss Lenox. There, in well lighted offices in the basement, he attended to the affairs of his estate, collected books, pictures and works of art and busied himself with many charitable and religious enterprises. Following the example of his father, Mr. Lenox was a Trustee of Princeton College, holding office from 1833 to 1857, and a Trustee of Princeton Seminary from 1831 to 1879. He was a director of the Seminary from 1835 to 1847. He received the degree of LL.D. from Princeton in 1867 and from Columbia in 1875. Since the retirement of Mr. Lenox the business house established by his father was continued under various firm names for many years. Stevens, apparently the sole biographer of Mr. Lenox, to whom I am indebted for much valuable information, says of him that he w-as not only born with a fortune but fortune made him her own through life. He was a pattern of industry, method and good management. He worked ten hours a day and accumulated largely by good investments. He could therefore well afford to choose his course of life. Mr. Lenox was ever most generous and charitable, but like many other great philanthropists, he manifested a dislike to being indebted to others for hints as to his private or public duties, nor would he tolerate interference with his own charitable impulses. He bore his share of the public burdens, and helped the needy, but avoided all public offices and politics. While living apparently to himself he was always earnestly studying the welfare of the public and that of posterity, ever tolerant in granting to others the fullest liberty in the exercise of the same privileges and principles of action which he himself assumed and practiced. lie thought that young- men prospered more successfully by attending to their own business affairs. By some he w-as thought proud, aristocratic and distant. To those who were in constant communication with him for many years he appeared diffident, simple hearted, generous, kind, very pious, but retiring and reticent to outsiders. To his intimates and especially to those in sympathy with his projects and pursuits he was freely communicative. With all his amiability and gentleness, none knew his duties better and, knowing them, none dared maintain them more firmly and consistently. He shunned notoriety, but when over35 THE LENOX LIBRARY FIFTH AVENUE, 70th AND 71st STREETS, NEW YORK taken by it bore it with fortitude and in silence. His love of exactness and especially of exact conformity to truth was sometimes almost excessive. He tolerated no interviewers or curiosity hunters and was himself not easily accessible except for good cause. A cultured reader, he was an ardent collector of books, but the treasures of his library, however precious, were generally with great promptitude and courtesy submitted to the use of scholars on due and satisfactory application, seldom, however, at his own house. Nor was he, with rare exceptions, willing to lend his choice books or let them go out of his possession. His usual custom, when requested, was to deposit his rarities in the hands of the Librarian of the Astor Library or some similar place of safety. Then by note, inform the applicant that the use of the particular book required was at his service there. He was nervous about the safety of his rarer books when out of his own keeping and almost uniformly declined application to see his library. He even refused among many others, Mr. Prescott, the historian, but at the same time politely informed him that any particular book or manuscript he possessed which Mr. Prescott might name should be forwarded for his use, if possible. The words "if possible" often used by Mr. Lenox in his replies to such applicants were sometimes incomprehensible to them. The truth was that from about 1845 to 1869, Mr. Lenox was actively and rapidly collecting his Library and doing all the work himself, so that he had no time to catalogue or arrange his accessions except in the case of a few of the smaller and more notable specimens. Thus, the request of Mr. Prescott involved great inconvenience to Mr. Lenox, the promise of little satisfaction to Mr. Prescott and the probable disclosure of intentions which for excellent reasons MIr. Lenox was not yet ready to reveal. For many years his highly competent agents had been diligently buying in Europe and elesewhere literary treasures of all kinds. Catalogues were gathered and studied, sales were attended and everything possible of interest and value secured. In 1854-55 his London agent alone bought books to the extent of over fifty thousand dollars, today worth five times that amount. The collection of Bibles, the third largest in the world, numbering over four thousand copies up to 1860 had cost eighty thousand dollars. The collection of Americana, chiefly from 1493 to 1700, is the finest extant. From the library of George Washington he secured 37 over three thousand volumes, most of them bearing the autograph of the original d'wner. The great bulk of his book collections were piled away in the numerous spare rooms of his large house, until these were filled from end to end to the ceiling. The door was then locked and the room for the time being definitely closed. The accessions after examination and careful collation, approval and payment, were entered or marked off in interleaved catalogues of various dealers or in small special memorandum books, with sufficient clearness for his own use but unintelligible to outsiders. The books were then piled away. "If possible" therefore, was a term which Mr. Lenox might fairly use but was not called upon to explain. Indeed, he often bought duplicates for immediate use or to lend, ratbier than grope for the copies he knew to be in the stacks in some of his store-rooms. The reasons for this course of action on the part of Mr. Lenox are perfectly clear. He intended to found a great library, of unusual character and scope; not a general public library in the ordinary sense but a collection of rare books and manuscripts not to be found elsewhere, invaluable for scholars and students of special subjects but far too precious for the use of ordinary readers, whose wants could readily be met in other ways. The intention and the character of the Library of Mr. Lenox bear an interesting resemblance to that of Mr. J. Pierpont Morgan. That his gift should be properly housed and preserved, he gave for it valuable land, the finest and most substantial building that could be planned and a generous endowment for its perpetual support, with every expectation that its permanence would be secure. The most striking commentary upon the fate of the Lenox Library is suggested in the rigid terms of the deed of gift of the J. Pierpont Morgan Library, lately made public. Years before it became expedient to erect a building Mr. Lenox began the work of collecting material for its contents. It was wise for many reasons that this work should be carried on quietly, as any exploitation of his ultimate purpose would have added greatly to the difficulties of securing rare and valuable specimens. Thus, while the extent of his collection was only known in a general way, he had acquired one of the finest special libraries in the world. My own personal acquaintance with Mr. Lenox began 38 shortly after I left college. He was then over seventy years of age. In his spacious home in lower Fifth Avenue he had for many years lived a quiet and retired life, although in the heart of the then fashionable part of the City. Those who were his neighbors were men of wealth who formed the most advanced social element of the time. Miany of them were more or less extravagant in their ways of living, lavish entertainers and genial men of that delightfully genial period. Some of them collected good pictures. Few had libraries distinctly worthy of note. The points of difference between themselves and Mr. Lenox were so many and so marked that it was as impossible for them to appreciate him as it would have been for him to exchange for their methods of thinking and living his own progressive and high-minded aims. Therefore he was criticized by them, often unjustly, sometimes even with unreasoning severity. It was my good fortune to hear about him and finally to know him through some of his most loyal and devoted friends, as well as to have fair opportunities for personal observation. This was especially the case during the period of my residence at the Presbyterian Hospital. I am able to bear ample testimony to the truth of all that has already been said regarding him. Of his modesty and self-effacement there can be no question. While he gave the property upon which the hospital stands and subscribed a very generous share of the money required for constructing it, he never allowed these facts to become apparent. No prerogative in the management of the affairs of the institution was arrogated by him nor did he allow himself to ask special favors of it, even of the smallest kind. As an example of this and by way of contrast, Mr. Lenox's pastor sent a patient to the hospital one day with the following note addressed to me as Resident Physician and Surgeon and Examining Officer: Dear Doctor: The bearer of this note is................. You will admit her to one of the female wards of the Hospital. Yours very truly.................. A day or two afterwards a patient applied for admission bringing a letter from Mr. Lenox, which read: 39 My dear Dr. Delavan: The bearer of this letter is............... Will you kindly examine her and if you find her case suitable for admission to the Hospital admit her accordingly? Yours very truly, J. LENOX. Mr. Lenox recognized the prescribed rule of the Hospital. The other peremptorily over-rode it. A kinder gentleman than Mr. Lenox or one more considerate of the feelings of others never lived. One bleak afternoon in the late winter time I was passing quickly down Union Square; a strong gale was blowing, the skies were overcast, it was very cold and the air was filled with clouds of offensive dust which swirled in all directions, choking one's breath and blinding his eyes. Coming toward me, and against the wind, I noticed Mr. Lenox, then seventy-seven years of age. In a heavy overcoat and with a shawl around his shoulders and head he was struggling to make difficult headway against the blinding gusts. As I passed him I touched my hat and said "Good afternoon, sir." Apparently he did not see me but when nearly by turned partly around, too late however to answer my salutation. Later I received a note from him, of which the following is a literal copy: New York, 23 March 1877. Dr. D. Bryson Delavan. Dear Sir: I have your note of yesterday, and have sent your memorandum to our Cor. Secretary to be incorporated in our annual report which has just been prepared. I am very much gratified by the opinion you express in relation to the hospital-perhaps at some future time you may again be brought into connection with it. About a month ago I think I met you in Union Square, but my sight is so defective that until we had gone too far apart I could not recall your face, nor where I had seen you. I hope you will receive my excuse for what may have appeared a rudeness. I am, dear sir, Yours very truly, J. LENOX. His interest in the Hospital was intense and he was by no means the least useful member of its board. Indeed, his 40 instinct in institutional management seemed to guide him with fair directness and accuracy. This is not surprising, remembering the experience of his father in hospital affairs and recognizing that it was with Mr. James Lenox that the idea of the Presbyterian Hospital itself was first conceived. Just when it originated in his mind may be doubtful, but knowing that the idea of the Library occurred to him many years before he saw fit to announce it, we may readily believe that he had long intended to do what was finally accomplished in the incorporating and building of the Hospital. Nor is it easy to imagine how long its inception and completion might have been delayed had he not developed the idea and then so promptly and nobly supported it. The very terms of its foundation were new, original and progressive. Mr. Lenox considered it wiser to enlist the support of a large and influential body of citizens through giving to the Hospital the name it now bears rather than to possibly restrict its influence through allowing it to take his own. In this was also presented an illustration of his unconquerable aversion to personal publicity. Great as was his vision of the Library, his other philanthropic projects were conceived upon a like breadth of purpose and liberality of view. This was especially true of the Hospital. Active although silent preparation for the Library occupied him for more than twenty-five years, during which time he was not only collecting material for it but was greatly increasing his financial resources, so that when the time was ripe means had been accumulated amply sufficient to meet the requirements of his long planned benefactions. The desire to found a hospital which should be based upon the best and most advanced conditions of the times, undoubtedly had been in his mind for many years. That he had given the subject the same careful thought bestowed upon the Library is evidenced by the excellence of the judgment and the value of the ideas contributed by him in the Hospital's organization. Silently, thoughtfullly, he had studied the subject of hospital construction and management until, when the time arrived, he was ready to render efficient aid. The story of the creation of the Library gives the best possible insight into the character of Mr. Lenox and explains in graphic detail the methods by which, with patience, 41 zeal and great intelligence his widely varied and difficult enterprises were carried by him to success. As Mr. Lenox advanced in years and took upon himself new responsibilities he felt more and more that his time, his intellect and his fortune were all his own in the higher sense and that they were the three talents especially entrusted to him by Providence for useful purposes. With rare conscientiousness and greatness of heart and with zeal commensurate with his diligence and his knowledge, he quietly persevered until he had finished all that he had begun. Like his father, in the ripeness of old age he was called away, just when he had attained his life's work. leaving nothing undone. A purer, cleaner and more finished life is hardly possible to conceive. Such was James Lenox of New York, w\ho died on the 17th of February, 1880, at the age of eighty, the earnest student, the collector, the founder and donor of one of the most valuable public libraries in the new world, the philanthropist, the builder of churches, the giver to New York of a home for aged women, the dispenser of untold silent charities, the benefactor of his native city and his honored country, the founder of the Presbyterian Hospital, the eminently worthy son of his distinguished father. Notwithstanding all of these noteworthy accomplishments, the outcome of a quiet and unostentatious life, Mr. Lenox was rarely seen of men, and few, from personal observation, could have divulged the particulars of any of his achievements. He was content to labor and to wait, his many virtues bringing to him their own sufficient reward. It has been generally believed that toward the end of his life Mr. Lenox expressly desired that little should be said regarding himself or his career. While such a wish should have met with due respect, 'it seems nothing short of a public misfortune that the story of such a life as his should be lost. Of shining examples of iniquity the youth of the country have all too many; not the least valuable of the legacies which Mr. Lenox left was the lesson of his own extraordinary character and personality. Men of elaborate training and of distinguished ability in the department of finance are not uncommon. Ripe scholarship, gained under peculiar social advantages, is sometimes met with. Combination of the one with the other is rare. It would be hard to find, within the recollection of those 1now living, another instance in which the highest order of 42 practical business ability, the broadest intellectual culture and the possession of ample wealth have been so harmoniously and so successfully united in one of such fine heredity and such marked superiority of character. In the world, but not of it, and possessing resources equal to the gratification of almost any desire, he lived for the happiness and well being of those around him and for their posterity, as remote as human foresight could previse. In his zealous furtherance of the noblest aims of philanthrophy and education the success of James Lenox must be ranked with the highest. Were any justification needed for this sketch of his character and career in connection with the Presbyterian Hospital it would be eloquently given by the earnest expression of that lover of great men, himself the greatest of them, Louis Pasteur: "From the lives of men whose passage is marked by a trace of durable light, let us piously gather up every word, every incident, likely to make known the incentives of their great souls, for the education of posterity." 43 EARLY DAYS OF THE HOSPITAL 1,11!, 1 IN, ml 1!1" IPl''1 '' 'IIi 00, i THE EARLY DAYS OF THE HOSPITAL In the foregoing sketch of the life and character of Mr. James Lenox an attempt has been made to describe the conditions which attended the founding of the Presbyterian Hospital and to recognize the highly altruistic spirit which actuated its founders. Filled with laudable ambition for the advancement of the relief of human suffering, they launched their enterprise at the very beginning of what was soon to become a veritable tidal wave of scientific progress. For years the ineffectiveness of many of the tim'e-honored methods of medicine and surgery had become increasingly evident. There had arisen an intense desire for better things, a longing almost prophetic of what was about to come. This desire was recognized by the founders of the Presbyterian Hospital, who made every effort to organize, construct and equip their institution in accordance with the most advanced prevailing ideas. In not a few things they were leaders, as our story will show. That some of their ideas failed of immediate acceptance was largely due to the'fact that they were new. Time and experience have fully vindicated their value. Incidentally, as one result of their example, the fame of their institution went abroad and there is today a "Presbyterian Hospital" in many of the large cities of the United States. Immediately following the period in which the hospital was established there occurred the most phenomenal era in the history of medicine. The investigations and discoveries of Pasteur were in progress and were soon to become known and the possibilities of their wide influence upon the correct understanding, the prevention and the management of communicable diseases appreciated. Rumors of the application of the discoveries of Pasteur to surgery through the work of Mr. Joseph Lister were slowly beginning to circulate. The world was fully prepared for the wonders it was about to receive. The mental attitude of our surgeons, discouraged by the experiences of the past, had become one of almost apathetic despair. With the reports from France and Scotland hope long deferred was giving way to anxious anticipation. The time was also one of radical progress in the his47 tory of hospital development and in the establishing of schools for the training of nurses in New York, for it was almost coincident with the removal of the New York Hospital from Duane Street and Broadway to its present quarters in 15th Street, and of the establishing of Roosevelt Hospital. Interesting differences existed between these three institutions which cannot here be discussed. In one thing they were alike; both of the newly founded ones owed much of the success of their organization to the influence of men who throughout their long careers had been intimately connected with the old New York Hospital. There they had enjoyed the best advantages that the time afforded for the development of professional knowledge and skill, as well as for the details of hospital organization and management. Practically all the older members of the Medical Board of the Presbyterian Hospital were men of high distinction, ripe in the experience of hospital affairs. The Board of Managers on the other hand was composed, with few exceptions, of men of prominence in the world of commerce and finance but with little practical knowledge of medical institutions. The marked exceptions to this were Mr. Appollos R. Wetmore, the son of a highly respected former superintendent of the New York Hospital, who was born in that institution and there spent his early days. By far the most efficient member of the Board was its President. Reared in the philanthropic atmosphere of his father's home his life had been spent in the study and management of important institutions. As a member of the Board he was intelligent, sympathetic and liberal. With the progress of time and the exercise of much patient endeavor the Board became educated to its task. The eminently favorable career of the Presbyterian Hospital in later years was doubtless influenced in no small degree not only by a knowledge of the causes which contributed to its earliest success but also through the recognition and avoidance of possible sources of failure. The story, hitherto untold, of its struggles through difficulty, and sometimes discouragement, may well engage attention. It presents instructive lessons. 48 THE ORIGINAL BUILDINGS P -i.:i 4 [IE~~R.:~: '~'h:~--j~ ~~:~ ~: a.~I~~ a 1;::~:: H wQ 0v [A [q [Al - 0G: ~ [A~r [AW` HlFJ II ~ THE ORIGINAL BUILDINGS It will be interesting to recall some of the original features of the Presbyterian Hospital as it was when first completed. They are admirably shown in the accompanying illustration. The buildings had been designed by the late Mr. Richard M. Hunt, at that time New York's most distinguished architect. The group consisted of two chief buildings, one for administration, the other for the hospital. Between them was a small structure which included the kitchen, laundry, and heating plants; another smaller one, the mortuary; and lastly, one for the ambulance. The ambulance itself, however, was not provided until a later day. The property of the hospital consisted of the block bounded by 70th and 71st Streets, and Madison and Park Avenues. Both the Administration and the Hospital buildings abutted upon the property lines of their respective streets and were connected by two long covered corridors, the tops of which could be used as roof gardens and were protected for that purpose by suitable balustrades. At that period there were no roof gardens at the tops of any of our hospitals. The walls of both buildings were constructed of red brick and gray stone; the brick was of the finest quality, Philadelphia, smooth faced. Its superior excellence illustrates the ambition of Mr. Lenox and his friends to provide nothing for the hospital not of the very best. The Limestone of "The Lockport group of the Niagara series of the lower Silurian," which provided the finish for the walls, is rich in the fossil remains of corals, crinoids, and various forms of small bivalve and spiral shells, especially evident where the surface of the stone has weathered, offering studies in the geology of the period pleasantly diverting to the hospital-wearied mind. The exterior appearance except in slight particulars remains unchanged. The plan of the old Hospital Building was simple. The first floor was mainly devoted to rooms for private patients, looking out upon 71st Street. These rooms were of fair size and comfortably furnished. The charge for them was from thirty to fifty dollars a week. The surgical operating rooms, located on the third and fourth floors, were remarkably well planned, in fact among the best of their day, al51 though lined with wood. Tile lining had not yet come into use. They commanded an excellent northerly light and were,conveniently equipped. There were three floors, reached by stairways, each floor divided equally into two wards of twelve beds each. The ceilings were high and the windows of the wards were large and numerous, so that excellent ventilation was secured. The walls were hard finished, capable of being washed. The flooring and other woodwork was of pitch pine. There weie no passenger elevators, access to the stories being gained by the staircase running up through the center of the building. All told, there were accommodations for about one hundred patients. The above described structures comprised the complete outfit of buildings as the hospital originally existed. All of the others are of a later date. For a number of years the approach to the front entrance of the Administration Building was guarded by two large and heavy wrought iron gates, set directly under the side arches of the tower and swung fronm the piers of the tower on each side, facing respectively east and west. These were closed at night. When closed they were architecturally effective. Practically, they were in the way. Moreover, by suggesting the idea of exclusiveness they offered direct contradiction to the open hearted liberality of Mr. Lenox as expressed in the tablet which he had caused to be placed upon the nearby wall. Thanks to Dr. Fisher, during his incumbency as Superintendent they were quietly removed. The scars in the stone work which represent the holes where the supports for the hinges were set and the ornamented iron pivots beneath them may be readily recognized. Except for the absence of the gates the entrance to the Administration Building remains unchanged. Even the doors are the same as is the clock above the corridor. The wooden steps which led to the corridor are now of marble and the wooden flooring of the corridor has been displaced, while the arrangement of the rooms giving off from the corridor has been extensively altered. Then, as now, the executive offices were in the rooms looking toward the south. Some of those on the north were used as reception rooms. The shop of the apothecary was at the extreme southeastern corner. The present partition wall, perforated with high windows, was built-in many years ago. The sleeping rooms of the superintendent and the interne staff were on the second and third floors. Mine was directly west of the central tower. The Manager's room 52 was the same as it is today. Our dining room was upon this floor, upon the north side. The chapel was a beautiful feature of the building. It was located in the upper and central part of the Administration Building, of Gothic design, well proportioned, sufficiently large, and altogether a successful example of the work of the architect. It is a pity that pressing need of space should have caused it to disappear, since a chapel is surely a good companion for a hospital. Indeed, in a hospital worthy of the name, it seems difficult to imagine that the one can exist without the other. Between the atmosphere of excessive sentimentality characteristic of some institutions, and that of scientific medicine reduced as nearly as possible to a basis of mathematical standardization, there must be for the evolution of the perfect hospital a happy medium. No better example could be found than is shown in that admirable institution, St. Luke's Hospital, New York. Such a combination was clearly intended by the Founders of the Presbyterian Hospital; the ambitious aims of the present should be tempered by the fine sentiment of the past. A striking contrast between the customs of the time and of our day of steel and concrete was shown in the construction of the hospital buildings. They were non-fireproof and wherever possible pitch pine was used. In the main Hospital Building a wide staircase led through the various floors to the upper story. Besides this there were separate shafts for dumbwaiters, soiled clothing and dust. These, together with small staircases, were placed at the extremities of the wings. All were lined with pitch pine. The Administration Building itself was not designed with reference to safety from fire. Several times fires originated in the shafts of the Hospital Building which but for the vigilance of those nearby might easily have ended in conflagration. I never retired without having my clothes arranged upon a chair nearby after the manner of firemen on duty, alway conscious of the fact that at any moment the necessity might arise for instant action. The reasonableness of this was subsequently verified, for in 1889 the main building, in which was the hospital department, was totally destroyed. It burned so quickly that it was with difficulty the patients were rescued and the most valuable orderly of the hospital lost his life in his heroic efforts to save them. The building was at once replaced by the present fireproof structure, greatly amplified and improved as compared with the original. THE TABLET PRES-YTERIAN HOSPITAL -QR THE POOR OF NEW YORK WITHOUTT RECARD TO:RACE,CREED OR COLOR SVPPORTe SBY VO`UNTARY CONTRIBYTIONS THE TABLET The most notable feature of the Administration Building was the tablet, placed conspicuously upon its outer wall a little to the west of the main entrance. The origin of the inscription upon it is interesting. Before the idea of the hospital had been announced by Mr. Lenox, he had many conferences upon the subject with his friend and personal physician, Dr. Oliver White. Mr. Lenox was frequently to be found in the doctor's consulting room, earnestly discussing his plans. Dr. White's practice was among the leading families of the neighborhood. On one occasion he was called to see an old and highly respected colored servant of one of them. He found her in urgent need of hospital care but was unable to secure admission for her to the institution of his choice, by reason of her race. I well remember the hot indignation with which he expressed himself to Mr. Lenox and others at this rebuff, earnestly venturing the hope "that some day there would be a hospital broad enough to admit patients without regard to color or creed." Mr. Lenox at once accepted the suggestion and applied it as the fundamental principle upon which the hospital was based. The idea met with universal approbation, and since then has been widely adopted by other institutions. But its actual introduction to the world was when it was first exposed to view upon the tablet so familiar to us. In the early days of the hospital the spirit of the tablet was carefully observed. Fifty years have dimmed the luster of its polished granite and tarnished the sheen of its bronze. The brightness of its youth has given place to the rust of age. May the future not find it totally obscured! 57 THE FIRST MEDICAL BOARD This engraving was made from a newspaper print, the only portrait available. THE FIRST MEDICAL BOARD In 1871, prior to the formal opening of the Hospital in 1872, the affairs of the institution had advanced sufficiently to warrant the selection and organization of a Medical Board. To this were appointed Dr. Alonzo Clark and Dr. Oliver White as Consulting Physicians, and Drs. George A. Peters and Johi J., Crane,''Consulting Surgeons. The Attending Physicians were Drs. A. Brayton Ball,, Edward 'C. Seguin, George G. Wheeldck, Walter de Forest Day, Gerardus H. Wynkoop, and Alexander Hadden. The Surgeons were Drs. Alfred C. Post, Gurdon Buck, Thomas T. Sabine, Daniel M. Stimson, Lockwood de Forest Woodruff. and Samuel B. Ward. The Pathologists were Drs. Charles Stedman Bull, Thomas E. Satterthwaite and John W. Beekman. Dr. Satterthwaite served continuously for fifteen years. The others resigned after a year or two. A detailed account of some of the most distinguished members of the Medical Board will be given in another section. The selection of the Attending Staff had been strongly influenced by Dr. Willard Parker. Several of its members, although young, were men of promise, while the staff as a whole, was exceptionally strong. Nearly all were associated with the College of Physicians and Surgeons. In the organization of the direct management of the Hospital Miss Jane Stuart Woolsey, a lady of social distinction and of proved experience and ability was appointed Superintendent, under the title of "Resident Directress," and Dr. Nelson B. Sizer, a recently graduated interne from Roosevelt Hospital, Resident Physician and Surgeon. Upon the completion of his services, Dr. Sizer established himself in Long Island, where he died about two years ago. He was succeeded by Dr. David Mount, also a graduate of Roosevelt and originally from a place called Rocky Hill, New Jersey. After him came Dr. Marcus E. Tully. Both practiced in this city for many years. They were succeeded by Dr. Thomas R. Savage, who was appointed Junior Assistant in the fall of 1873. Dr. Savage resigned before the close of his term and his place was filled by Dr. Edward T. Ely, son and grandson of eminent practi61 tioners of Rochester, New York. Ely was one of the most talented and attractive men of his time. After leaving the hospital he became the partner of the late Dr. D. B. St. John Roosa. He developed unusual ability as a specialist in diseases of the eye and ear and also distinguished himself in general literature. But his brilliant career was brought to an early close, and there went from us one of the most promising scientists and best beloved friends of his time. In my judgment Ely was by far the ablest man who served the hospital during the first twenty years of its career. He was succeeded by Dr. John B. Crowell of whom I have found no record, and Crowell by Dr. Charles B. Roof, of New York City, who practiced here for a time and died many years ago. 62 THE RESIDENT DIRECTRESS . ý.. 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I'll f,ý,,,ý,-,., - ý -,, ý,, ý. 1.., I I,. ý!ý ý, I,,., -: ý - - ý,.," ý -, - ý,. - ý. ý ý I., I -, - j:, ":ýý ý,,ý::, " ý, ý I,.,ý, I, ý,,,,;,,ý., I, -,::. ý -!,, -,ý ý,,ý - " ý I -.ý ý.:.. ý -Z1., ý... " -ýý I 1: ý 1ý,,-.ý.: ", ",., I ý, ý -,,,::... I,,,,.,: 1ý I,::,::. ý ý, I I ý. ý. ý, I I ý,.., j,, ý, -,,...-, I,::. Pý ý, 1. ý ý i ý.,,`,,, I - ý,:.. - I I ý:. ý: I ý 1 I.: ý,, ý ý -,, 1 I ý ý ý,,,.ý,..-", ý I I -,..... ý ý. ý,, 1ý ý,., I,,ý, I n ý ý I I, I ý I I I,, I, -, ý I ý1, I, ",ý, ý 3" ýý, 1 ý,,, " - ":',, ý,ý,,- "...... - ý: I.,.' -,:ý ý,::ýýoýý,,,,*,..ý ý..,, ý,:, I. ý, THE RESIDENT DIRECTRESS The successful establishing of a great institution is no light task. In the case of the Presbyterian Hospital this was eminently true. The enterprise in all its aspects was absolutely new. Buildings, equipment, managers, physicians, nurses, attendants, and servants were all brought together at once, the latter unfamiliar with the place and with each other. Time was needed for the proper understanding of men and things, not only as to the individual duties of each but for the necessary mutual adjustments. The care of the buildings had to be provided for, the drug, kitchen, supply and other departments established, nurses trained, servants instructed, dietaries studied, and all of the numberless complex details of an elaborate system assembled, developed and coordinated. To the Resident Directress, and to her sister and able associate Miss Abby Woolsey, is due the credit of having effected the original organization of the Hospital. Highly competent through liberal training and experience to conduct the complex duties committed to them they strove for the highest standards of excellence and were successful in attaining them. The work of Miss Woolsey during and after the Civil War had seriously impaired her strength. The burdens necessary to her position at the Presbyterian Hospital made still further demands upon it. In 1874, after two years of arduous service, in the course of which the complete organization of the hospital had been effected, she wished to be relieved and to that end presented her resignation. At the earnest request of the. Board of Managers the resignation was withdrawn.. Meanwhile, among the younger members of the Medical Board were several who from the outset had opposed the appointment of a lady superintendent and had refused to reconcile themselves to her presence. One of these flagrantly broke the stringent rule of the institution against the admission of infectious cases, sending to his wards patients suffering from the types of infection most particularly forbidden. To this Miss Woolsey necessarily objected. Her objections were resented by the offending party and a few of his immediate friends, with such open 65 opposition as to cause them to be dropped from the MIedical Board. The result of this action caused an upheaval. Many of the remaining members of the Medical Board resigned and for a while a spirited controversy was excited. Gentlemen of excellent standing in the medical profession were found who were brave enough to risk personal unpopularity by accepting positions upon a newly formed staff, in order to save this splendid institution from defeat and to enable its excellent work to be continued without interruption. In this they were successful. Perhaps the most important lesson taught by the event, then referred to as "the Presbyterian Hospital affair," is, that as long as a Medical Board holds its position by appointment from a legally constituted Board of Managers the former is in no position to dictate to the latter. "The institution is stronger than the individual." One practical outcome of it has been the almost universal adoption of the custom of limiting the tenure of hospital appointments to one year, subject to reappointment. The action of a few of the younger members of the Medical Board who, blinded by their own self-importance did not hesitate to oppose the Resident Directress, imperilled the very existence of the institution and actually set back its progress many years; for it was not until Dr. Fisher and Miss Maxwell appeared that it began to readvance upon the high level so successfully established by its devoted and self sacrificing first superintendent. The criticism and opposition as applied to the Resident Directress were not as much personal as general. Miss Woolsey herself was a lady of aristocratic lineage and personality and of ample means. Her services to the Hospital, as to all of her philanthropic work in general, were in point of fact gratuitous and she gave liberally of her private means besides. Accustomed to receive the deference and respect for which her character and position called, her experience at the Presbyterian Hospital must have been disquieting. Little wonder that her health gave way under it and that her retirement followed.'' Fortunately for us the correspondence attending the departure of the Misses Woolsey has been preserved. Any question which might exist as to the sentiment of the Board of Managers of the Hospital toward the Resident Directress and her sister is immediately dispelled by the terms of pro66 found appreciation expressed. The letters explain themselves:Miss Jane Stuart Woolsey: At the last meeting of the Managers of the Presbyterian Hospital, your letter to the Visiting Committee, bearing date of November 17, 1874, tendering your resignation, at that time, of the office of Resident Directress, was read to the Board. This communication was heard with mingled surprise and regret. The Board would have instantly and earnestly requested you to withdraw this resignation had they not been assured by the Visting Committee to whom it had been entrusted and by others that, as it had been so long under your deliberate consideration, such a request would be unavailing. With great reluctance therefore the Managers were compelled to accept your resignation and the undersigned were appointed a Committee to express on behalf of the Board their gratitude to you for your invaluable services these years past and their profound regret that these services are so soon to terminate. In discharging the duty assigned to us, we would not be thought to be acting merely in a formal and official capacity. We have been witnesses of the unselfish devotion with which you have given your gratuitous services to the interests of the Hospital even as you volunteered similar aid in the cause of philanthropy and patriotism among the wounded soldiers in our recent war. We know at what a sacrifice of personal ease, by day and by night, you have sought the comfort of the sick and the relief of the suffering. We thank you for the admirable executive ability displayed by you both in the organization and administration of the Hospital, and for the many delicate ministrations and tender sympathies which have evoked the grateful acknowledgment of those who have sought solace within our walls. Begging you to accept the cordial assurance of our gratitude and esteem, our prayer in your behalf is that you may be compensated, through the whole of life, by the consciousness of having sought the good of others and that you may hereafter be welcomed by Him who regards offices of kindness to the sick as done unto Him67 self.:VW,ith sincere regard, we subscribe ourselves, dear Miss Woiolsey, in the name of the Board, WVILLIAM ADAMS, D. D., WILLIAM M. PAXTON, D. D., OTIS D. SWAN. New York, March 1, 1876. Miss Abby Howland Woolsey: At a meeting of the Board of Managers of the Presbyterian Hospital held this day, the undersigned were appointed a Committee to express to you the thanks of the Board for your services to the Hospital. In so doing we are pleased to assure you of both the collective and individual esteem of the members of the Board for you personally, as well as their high appreciation of the services which, for a year and a half, as Acting Clerk of the Hospital, and as at times (during the temporary absence of your sister) as executive officer, you have so cheerfully, and so faithfully and satisfactorily given. Be pleased to accept therefore the sincere gratitude of the Board. Such beneficence can only find its reward here, in your own consciousness of "good deeds" and in the grateful remembrance of those you have so kindly served. Very sincerely yours, A. ROBERTSON WALSH, HENRY M. TABER, Committee. New York, April 18, 1876. THE FAREWELL LETTER OF MISS JANE STUART WOOLSEY Upon taking final leave Miss Jane Woolsey wrote a letter of farewell to the nurses and employees of the iHospital. The wisdom and eloquence of this letter make it a classic of enduring value. Miss Woolsey's golden words are as precious today as they were when they came from her very full heart more than half a century ago. They reflect-that beautiful spirit, which, largely through her influence, dominated the early years of the Hospital. 68 Presbyterian Hospital, March 20, 1876. To the Employees of the Presbyterian Hospital. Ally dear friends and fellow workers: I cannot leave the place in which we have lived and worked so long togo-ether without a word or two of thanks and farewell. Some of you stood by my side in the first days of the Hospital. Almost all of you have served with me through many months, and even years of labor here. I thank you, from my heart, for your long, patient, loyal service to the Hospital, to the sick and helpless poor and to myself, as your friend and teacher, and the head of your household. I believe that our aim has been one and the same: to do our very best for those whom misfortunes have thrown into our care, and to do it heartily, and as to the Lord and not to men. In the name of these helpless ones, and for the sake of the great Friend and Healer, I thank you for your loyal service. Whatever changes may happen here, I hope you will all stand steadily in your places and go on, doing your best. You are serving one M aster who is always the same. Do not count any service in His household as "menial service," if it is only the sweeping of a room, or the cooking of a mess of broth, or the emptying of a refuse bucket. In foreign countries a Hospital is called "Hlotel Dieu," God's Hotel. Remember whose guests you are entertaining. Remember more than this: that a poor hod carrier is only the type of the King Himself, and that one of the supreme tests will be: "I was hungry; I was in prison; I was sick; and ye ministered- or ye ministered not- unto Me." Keep the standard of your work very high. Slight nothing. Despise a poor and cheap quality of work; mere eye-service and man-pleasing. Never give your countenance to anything like bad or deceitful conduct or the evasion of rules or of rightful authority. Despise all underhand and round about courses. Walk sti-aight forward with your faces to the light. Try to make no mistakes, but if honest mistakes happen, as they sometimes will, bear the blame cheerfully; bear anything rather than the meanness of shifting the blame to someone else's shoulders. Despise and discount69 enance gossip and tattle. Never allow yourselves to tattle about your patients or to listen to those who do. The involuntary confidence of the sick as to their diseases, their personal histories, their family life and troubles, are part of their misfortune. Respect them. If they come to your knowledge, hold them sacred. There is a large class of persons in the great public hospitals, some of whom find their way even here, whose sickness is the direct result, not of misfortune, but of vice and shameful living. You have sometimes found it hard to work for such persons, This is natural. Nurses and attendants whose lives are clean and whose standard is high often feel it hard. They feel as if their toil were thrown away. Do not feel so. Be even more patient and gentle with this class. While they are helpless in your hands you have nothing to do with their guiltiness, only with their suffering-and the word or two you may find a chance to drop, or the mere sight of your good will and faithful care, though you say nothing, may do them more good than you will ever know. Of course, if you see on the part of such persons any attempt to corrupt others you should at once make your respectful protest to the person next above you in authority, your Superintendent or the head of your nursing department. Avoid petty disputes and jealousies among yourselves. Do not be easily provoked. Settle your little differences frankly at once or they will grow and get the upper hand of you before you know it. Help each other. Pull together, not apart. Bickerings and cross-purposes in a household like this hinder business and work downward into discomfort and suffering for the sick. Save your earnings and lay them by for a rainy day. Keep yourselves always neat and bright but spend the least possible sum upon your persons. Save your health. Your business is a very wearing and exhausting one. Economize labor by putting thought into it. Study over it and see how you can make it more systematic and thorough. Nothing saves work like thinking it over and arranging it before hand. Save your health also by prudent eating and by getting as much exercise in the open air as possible. Save your time. You have a little leisure. Spend none of it in idle company or worthless reading. Try to get half an hour a day-you 70 can do it-to give to some good book. You know which is the best of books. In this way you will lay by treasures which no broken bank can ever cheat you out of. I think you will say you agree with me in all this. I hope you will act upon it just as if I were still among you, helping and directing you, day by day. This is the best remembrance you can give me. My remembrance will always follow you and I shall rejoice to hear of your welfare and your continued faithful service herefor which, once more I thank you, with all my heart. And now, dear friends and fellow-workers, God bless you, and farewell. JANE STUART WOOLSEY, Resident Directress. 71 REORGANIZATION AND REMINISCENCES DAVID BRYSON DELAVAN, A. B. (YALE), M. D. 1877 THE REORGANIZATION The influence of the events before described was momentous, necessitating as it did, among other serious results, the complete reorganization of the medical and executive staffs. The Medical Board as reorganized consisted of the following members: Consulting Surgeons Gurdon Buck William Detmold William H. Van Buren Visiting Surgeons Alfred C. Post Charles K, Briddon John H. Hinton Lewis Atterbury Stimson William T. White Consulting Physicians Oliver White Jared Linsley Visiting Physicians Alexander Hadden James Lenox Banks Frederick A. Burrall Samuel T. Hubbard Gouverneur M. Smith James V. S. Wooley Pathologist Thomas E. Satterthwaite I succeeded Dr. Roof, as House Officer, April 1st, 1876, following the appointment of the new Medical Board, the resignation of Miss Woolsey and the loss of the whole interne staff. A new Superintendent had been appointed and the membership of the house staff recruited from recent graduates in medicine. I had just finished a full term of service at the City Hospital and was appointed Resident Surgeon and Physician, upon a salary, for a period of six months, so that the junior members of the staff might receive some little practical training before being entrusted with the full duties of their positions. The staff consisted of myself and four junior assistants. According to the original arrangement Miss Woolsey was to have retired from the hospital upon the last day of March, and the new Superintendent and myself were to come on duty the following day. Owing to some mishap, the coming of the new Superintendent was delayed 75 for a fortnight, Miss Woolsey remaining- until his arrival. During that time an excellent opportunity was afforded to observe her methods of management and to become still better acquainted with her. Upon taking up the duties of Resident I found that the executive staff consisted of a new, untried and inexperienced superintendent, an accomplished elderly apothecary, the good Mr. Marsh, the head nurse, Miss Rafferty, and the engineer, Mr. McMasters. All of these, carefully trained under Miss Woolsey, were excellent officers and persons of first class character in every respect. I am under deep obligation for the practical help received from them upon many trying occasions. Of the house staff, four in number, all were but just graduated and had had but little experience in any way excepting Dr. Jacob A. Van Houten and Dr. Augustus Buiichler. The others, Drs. W. H. Haynes and W. E. Forrest, were unable to perform the simplest duties of a ward attendant. However, they all made good progress in the work of their positions. Van Houten attained excellent success after graduating, but died early. Haynes established himself in New York City, developed well, and left us a few years ago. Biichler, now a well known specialist, remains the careful scholar, the sound practitioner, and the delightful gentleman that I found him upon the first day of our acquaintance. My relations with the house staff were most agreeable, although our work was strenuous and practically neverceasing. This latter fact was owing to many causes, among them the lack of satisfactory organization of the work of the Attending Staff and of the hospital under the new superintendent, and also to the fact that operations were performed and cases treated not only by the attending surgeons and physicians but also by the consultants. Several of the latter operated frequently. Often the nursing staff was inadequate to the demands made upon it, cases were frequently severe and of a nature requiring much attention, and the untrained staff was too inexperienced to afford much aid. The duties placed upon the House Officer were laborious and exacting. The service, however, was most instructive. With such distinguished surgeons as Gurdon Buck, Van Buren, Briddon, Post, Detmold and Stimson, hardly a day passed without something of great value and interest presenting itself. While on the medical side the interest was not so great, there were nevertheless, some features which were particularly good. Of these I would 76 especially, mention the remarkable knowledge of psychology and the fine skill displayed by the late Dr. Samuel T. Hubbard in the treatment of hysteria. His success in this department was well known, so that many patients were referred to him. Altogether he was in every sense a splendid representative of the general practitioner of the old school. I have known no specialist since whose results in the treatment of this particular neurosis have been better. The instruction which I gained from him has been a matter of lifelong benefit. Any spare time that remained to us in the long rdund of our daily duties was consumed in the recording of case histories. After the severe work of the day this was a most laborious and wearying task, but one which was conscientiously undertaken by the majorit)yof the staff. In view of the highly important character of many of the cases these histories, although recorded with less scientific detail than now, were often interesting and sometimes of distinct value. Notably those recording the first application in this country, by Dr. Lewis A. Stimson, of the principles of antiseptic surgery. Unfortunately, the case records, made by us, and our successors, were destroyed by the fire of 1889. Our routine as internes was the usual one,-with additions. Rounds were made in the mornings. Attendings generally called in the afternoon and we accompanied them through the wards. Operations were nearly always performed in the afternoon. Rounds again in the evening. There were six good sized wards and a number of private rooms. Owing to the lack of experience of the assistant staff, practically all of the special work devolved upon me. Thus, I made all rounds, both with the assistants and with the visitings. Often several visitings besides those on regular duty would call in one day. Of course I had to superintend the operating room and assist at all operations. Many of these were performed by the Consulting Surgeons, who operated frequently. Calls to the wards and to the private rooms were incessant. The hospital being new and considered a model, was frequently visited by out-siders, both medical and lay, of all descriptions, including- rich patrons, possible prospective donors, interested or curious people from the city, strangers from all parts of the country, now and then distinguished foreign guests, and doctors from everywhere. All came to see the model hospital of the day. 77 Almost invariably they were entrusted to my care. With no elevators, the stairs, towards evening, seemed to me to grow as long and tiresome as the last steep approach to the top of the Matterhorn. Far from objecting, I welcomed the opportunity of meeting these large groups of influential people, many of whom became valuable friends. Nor were these all the demands made upon time, patience and strength. Among the most burdensome of all were the constant calls of the superintendent for assistance and advice in the management of his own affairs. Again, owing to the lack of skilled nurses,!night calls were frequent. I seldom had a consecutive night's sleep and was often called several times. During a particularly busy period, I retired one night, greatly fatigued, having given strict orders not to be disturbed unless under urgent necessity. At 2:30 A. M. a female nurse aroused me, reporting that a private patient with "nerves" was "very bad" and needed me at once. Dressing with diligent haste, I repaired to the patient who greeted me with a radiant smile and said "Doctor, I waked up a little while ago and thought that if you would come and sit down by me and let me hold your hand, perhaps I could go to sleep again." Through the treachery of the nurse my appearance at the breakfast table that morning was greeted with the above quotation, shouted in gleeful chorus by the assembled internes. All things considered, under the sympathic care of one of the fine practitioners of that day, whose well grounded ideas of therapeutics were tinctured with experience, flavored with mercy and suspended in a strong solution of common sense, aided by a good representative of the best type of the old fashioned nurse and in the absence of an excess of "bed-side instruction," the lot of the comfort-seeking patient in the beautiful hospital of Mr. Lenox and his friends was by no means bad. 78 ENVIRONMENT AND MORE REMINISCENCES ~ -3 012r r~ H rj - F-~ Ar: i; -'-1 ENVIRONMENT When the hospital was opened there was some criticism that it should have been placed so far up town. Under the conditions of its location and surroundings it is not strange that the residents of the then fashionable quarter, centering below 23rd Street, should have found 70th Street far away. Access to it was difficult. The nearest approach was by the horse-drawn cars of Madison Avenue. From the hospital these required more than an hour to reach the City Hall and after midnight did not run northward beyond 32nd Street. The "Lenox Farm," so called, embraced the property extending from 68th to 74th Streets and from Fifth to Park Avenues. The land was more arable than much of that west of it nearby, and in former years like other of its kind had often been leased to market gardeners. Indeed, it was not uncommon for the fashionable residents of Washington Square to personally drive up town for the purchase of the family vegetables. Much land was broken by rocky ledges and was unfit for cultivation. In these places vegetation was sparse and rough. One of its most noticeable features was a variety of cactus which at the proper season bore a small yellow flower but at all seasons presented numerous fine, needle-like prickers, very damaging to the fingers of youthful botanists. Far and wide these rocky places were occupied by people of the poorest kind, who built for themselves huts made of refuse boards and old tin roofing and finished them with cast-off doors, windows, stovepipes and whatever else of use could be acquired without expense. Some of these huts were fairly comfortable; the majority had but one room. There was no pretense of sanitation, and little of cleanliness or even decency. A few of the "squatters," as they were called, kept a badly nourished cow. They all had a milch goat, while pigs, ducks, chickens and pigeons were common. Dogs were abundant. The squatters themselves made precarious livings as junkmen, hucksters, laborers and sometimes as thieves. They were a generally unsavory and undesirable clan, who knew not prohibition. Wherever were rocks, there the squatter built his castle. From such forbidding material did the 81 artistic mind of Mr. Frederick Law Olmstead evolve tht beauties of Central Park. In the 70's Central Park had begun to take form and to merit the claim of being the most beautiful pleasure ground in the world. It afforded great attraction for our convalescents who, whenever possible, utilized it. Then existed the Park carriages, long ago discontinued. The Park carriage, so called, was a large open barouche, with two seats inside which faced each other and were wide enough to comfortably seat three persons. There was also an extra seat by the driver. Thus seven passengers could be accommodated. The carriage was drawn by two horses of sedate demeanor whose slow gait gave ample time for the enjoyment of the scenery and the fresh air. The drive from the hospital around the park consumed about an hour. Funds for providing the patients with drives were provided by generous friends, often by Miss Woolsey. It is unfortunate that this highly valuable and most appreciated privilege could not have been continued. Fortunately, the hospital now has the advantage of the roof garden. My room was on the southwest side of the Administration Building, facing 70th Street. There were few buildings between us and 59th Street. The menagerie at the Arsenal at 64th Street had at that time a fine collection of particularly large and lusty sea lions, who rejoiced in greeting the first flush of dawn with uncanny uproar. Even at the distance of eight blocks away I was frequently awakened by them, always when the wind was from the south. The loss of the early morning sleep was serious. The menagerie itself in those days was a highly creditable institution, new, finely equipped, well-cared for, and popular. The display of animals was good. The pride of the collection was a lion, a really splendid specimen. He was the means of introducing to us one of our most interesting cases. A stalwart gentleman of genial nature who was an enthusiastic lover of animals and of certain other things then not forbidden, visited the menagerie one quiet afternoon after having dined. He found the lion asleep, lying with his head near the front of the cage. Overcome with admiration our somewhat unsteady friend addressed him in friendly terms, at the same time thrusting his arm between the bars and patting the beast upon the nose. Following a few moments of continued repose the lion suddenly aroused, uttered a terrific roar, sprang at the man and seized his arm at the shoulder with both paws. The man, 82 large and powerful, threw himself backwards with a mighty effort. He was brought to the hospital with a series of deep, ragged lacerations which extended from the shoulder to the wrist. The wounds were, of course, infected and the result serious, although recovery eventually took place. On a certain occasion a call came to the hospital asking me to make a professional visit upon a "lady living a few blocks up Fifth Avenue." With visions of the aristocracy of lower Fifth Avenue in mind and greatly elated at the thought of my first real private patient being a resident of that famous street, I dressed with care and went to find-an old Irish woman with chronic rheumatism, lying upon a pile of filthy rags on the floor of the squatter hut of her son, a junkman, and sharing the one room shanty with his family of many children, several chickens, a shegoat, a dog and sundry other less visible specimens, the special activities and natural history of which I learned more intimately after reaching home. As examples of growth contemporary with that of the Presbyterian Hospital and occurring in its immediate neighborhood the following, among many others, are interesting. Prof. Albert H. Bickmore, an eminent student of natural science, had secured space in one of the upper rooms in the old Arsenal building where he deposited a small collection of minerals and there began the work which, by his rare energy, foresight and enthusiasm, so stimulated general interest and support as to enable him to organize and develop our splendid American M/Iuseum of Natural History; while the menagerie to which reference has already been made was the forerunner of the great Zoological Garden in Bronx Park. The summer of 1876 was one of the hottest on record. Many cases of heat prostration, from among the men employed in Central Park as well as from other quarters, were brought to us, conveyed by their friends in any available vehicle, our hospital being the only place of refuge within practicable reach. 83 CONTRASTS CONTRASTS One of the contrasts which produced th most forcible impression upon me was that of the liberality of the management of the Presbyterian Hospital as compared with the extreme economy observed in the large Municipal Hospitals in this and other cities. I had recently completed a full term of service as Interne at Charity Hospital and was familiar with its restrictions as well as with those of Bellevue. In such institutions it was necessary to treat patients at the least possible expense. The cost of medicines, surgical supplies, and diet, rigorously restricted to meet the figures of narrow appropriations, were still farther reduced by the political influences apt to beset institutions for the care of the unprotected poor. Consequently our means and methods were often crude, and little opportunity was afforded for the study of advanced therapeutics or for the acquisition of those refinements of treatment, nursing, and dieting so essential to success in private practice. Many an otherwise able practitioner has failed because unable to lay aside the unconventional manners of the hospital and to avail himself of the resources and refinements easily procurable in the higher walks of life. The management of the Presbyterian Hospital was most liberal. Expensive drugs, surgical equipment and nursing supplies were willingly furnished when it was shown that they would afford better results. Everything was provided for the patient that would be given to one in easy circumstances, being cared for at home. After the experiences of the meagre supplies of the City Hospitals and the necessarily primitive ways of handling patients the breadth and the refinement of the generous facilities of the Presbyterian Hospital were an invaluable education to me, and a splendid preparation for the possibilities and the exactions of private practice. Again, many differences existed between the conditions and customs which prevailed at the time of the opening of the Presbyterian Hospital and those which exist today. In nothing is this more conspicuous than in the changed attitude of hospital managers toward that important position known as hospital superintendent. Then such men as have adorned our leading~ institutions for the past generation 87 C. IRVING FISHER were almost unknown. Among those of our time who have distinguished themselves in this department, in New York, let us recall Mr. Ludlam of the New York Hospital, Mr. Lathrop of Roosevelt, Rev. Mr. Clover of St. Luke's, all laymen, Dr. Goldwater of Mt. Sinai, Dr. Hurd of the Johns Hopkins Hospital and last, but by no means least, deservedly respected of all, Dr. C. Irving Fisher, whose service to the Presbyterian Hospital of thirty years was one of real distinction, a contribution to the development of the hospital of undisputed value. A warm friend of many years, the news of his death came to me bringing with it a deep sense of personal loss. The superintendent during my residence at the hospital was a sad contrast to those mentioned. He had come from a small up state town, was intensely provincial and utterly unfit by nature and experience for the duties of his position. Into his hands were placed the important affairs of the hospital at a time when its management needed strength, energy, experience and tact. We of the staff had our meals with the superintendent and his wife. In his anxiety to gain favor with the managers by the reduction of expenses almost his first act after appointment was the ruthless cutting down of the excellent dietary furnished to the staff by Miss Woolsey and never objected to by any of the Board of Managers. We dined in the middle of the day and after our meagre and unsatisfactory supper the pantry was closed and it was impossible to get anything until breakfast the following day. A midnight lunch was unthought of. Called as we were at night after long days of hard work and often obliged to spend many hours of exhausting labor in the wards when we should have been in bed, this restriction of diet proved a severe hardship. The vicinity of the Presbyterian Hospital in those days was very lonely; there was no possibility of securing food but at the restaurant in Central Park at McGowan's Pass or from those upon Third Avenue. The first was too far away and very expensive; the latter were low saloons, many of them absolutely dangerous. There were no places of respectability anywhere about and the neighborhood was infested with a rough element, lawless under the lack of police protection which had characterized the rule of the Tweed ring. The experience was a novel one to the staff, hitherto accustomed to wholesome and abundant living, and until we learned to provide ourselves with private supplies we were often uncomfortable. No graver mistake 89 can be made, no greater injustice inflicted than the withholding fromn a hardworking, faithful interne staff, or from the zealous young members of the nursing corps, the proper allowance and variety of wholesome and appetizing food. In our case the actual success of the hospital work was seriously interfered with by the fact that we were often not in proper physical condition, so that our tempers as well as our digestions suffered much resulting irritation. The typical hospital interne, young, enthusiastic and faithful, receives no salary for his hard work. In addition to the strain of his routine he is often exposed to serious physical risks, especially of infection. His vitality should be sustained at a high pitch. For every reason he requires the best of good nourishment. The least that the hospital can do to protect him and to requite his services is to see that he gets it. In the planning of the hospital routine no provision whatever had been made for recreation, either for the internes or the nurses. Tennis was practically unknown in this country. The hospital courts did not appear until after the lapse of many years. The situation of the hospital was so isolated that outside amusements were far away, while indoors our duties were heavy and continuous, affording little time for relaxation. Such spare moments as might occur were absorbed in the writing of histories, an irksome and laborious part of our necessary work, for in those days we had neither stenographers nor printed forms. All had to be elaborately written out in long hand, upon the never-ending pages of large, cumbersome, heavily bound books. Games were not provided nor was there any gymnasium or other place for exercise,-except the main staircase. For some time before entering the hospital I had been spending part of one evening each week in company with three friends, at our various residences, playing oldfashioned whist. We never played for stakes, and refreshments were confined to crackers, cheese and lemonade. We spent one evening thus in my room at the hospital. An evilminded nurse assured herself of thle strange proceeding through my half open door and reported it with wild exaggeration to the credulous superintendent who at once carried the story to the Board of Managers. Greatly shocked, the 'managers thereupon uttered a stern reprimand and passed the stringent rule against "drinking and card playing" which doubtless obtains to the present day. But in forbidding our innocent whist and lemonade they provided no substitute. We w'ere left where we began, with nothing 90 either physical or mental in the way of recreation, and we suffered accordingly. The superintendent was retired in 1879, after a term of three years, and from the date of the appointment of the late Rev. Thomas G. Wall, the star of the hospital again became in the ascendant. Always courteous, dignified and considerate, and perfectly fair to all with whom he came in contact, his attitude towards the house staff was broad and humane. Although it was never my privilege to have been well acquainted with that most excellent man, I have every reason for knowing that he was a gentleman, refined, of good education, judgment and intelligence. While he may not have belonged to the modern type of highly trained specialists who so well represent his particular profession today, yet his sterling qualities made generous amends for any such lack. He commanded respect, both within the institution and outside of it. Following his retirement in 1892 his declining years were spent peacefully with his family, which consisted of his wife, a son and two daughters, both of whom married promising young internes of th.e Presbyterian Hospital. One of these was Dr. John A. Wells, a son of the late Mr. Ralph Wells, of New York City, widely known by reason of his interest in Sunday Schools. Dr. Wells lived and practiced in Englewood, New Jersey, until his death, which occurred about twenty.years ago. The other daughter became Mrs. Dr. Herbert S. Little. It is to be regretted that after diligent search we have failed to find a portrait of Mr. Wall of any kind. 91 SURGERY 1872-1876 JOSEPH LISTER LOUIS PASTEUR SURGERY 1872-1876 The opening of the Presbyterian Hospital, in 1872, found the world of medicine enshrouded in the darkness which had obscured it from beyond the memory of man. True, glimmerings of the dawn had already appeared, heralded by the great discovery of Jenner, and Dr. Oliver Wendell Holmes had recognized that puerperal fever was infectious. But daylight seemed still far away. Disregarding the consideration of that dread scourge diphtheria and of the other communicable deadly diseases, the terrors of the surgical practice of former days, faced meekly and with resigned despair by both surgeon and patient, such as unavoidable suppuration, pyemia, septicemia, erysipelas, tetanus, and, worst of all, hospital gangrene, are today almost beyond imagination. Thus, in a noted Germinan clinic eighty per cent of all wounds were attacked by hospital gangrene. Erysipelas was almost unavoidable. Primary union never occurred. Suturing of a wound would have led to retention and the further encouragement of erysipelas. Within one year eleven out of seventeen amputation cases died of pyemia. In cases of compound fracture amputation was performed immediately, otherwise infection led to a fatal termination in a few days. In another famous German clinic the usual rate of mortality in compound fractures was fdrty per cent. In this country the rate of mortality for major operations was about thirty-three per cent. The best record gave twenty-eight per cent, the highest about forty-eight per cent. In St. Petersburg, Russia, it reached as high as sixty-eight per cent. In those days the healing of the wound after removal of the breast required from three to six months, in case the patient survived. As with surgery, so with the statistics of midwifery which, during so called epidemics of puerperal fever were appalling. In Great Britain and Ireland the very name "Hospital" had become the despair of the surgeon and the terror of the people. Sir Frederick Treves, of London, one of the great surgeons of the century, writing before the World War, speaks feelingly of this period. Like myself, he entered 95 professional life in the pre-antiseptic era. Sepsis was accepted and expected as a "natural" concomitant of surgical procedure. He says:"There was no object in being clean. Indeed, cleanliness was out of place. It was considered to be finicky and affected. An executioner might as well manicure his nails before chopping off a head. The surgeon operated in a slaughter house. The surgeon's frock coat of black cloth was stiff with the blood and filth of years. The more sodden it was the more forcibly did it bear evidence of the surgeon's prowess. I, of course, commenced my surgical career in such a coat, of which I was quite proud. Wounds were dressed with "charpie" (or lint) soaked in oil. Both oil and dressing were frankly and exulting septic. Charpie was a species of waste obtained from old linen, scraped. It would probably now be discarded by a motor mechanic as being too dirty for use on a car. 1 remember a whole ward being decimated by hospital gangrene. The modern student has no knowledge of this disease. He has never seen it, and thank heaven, he never will. People often say how wonderful it was that surgical patients lived in those days. As a matter of fact they did not live, or at least only a few of them." Dr. Henry M. Silver recently delivered an address before the surgical section of the New York Academy of Medicine in which he graphically and in detail described the conditions and methods which prevailed at Bellevue Hospital in the period prior to the introduction of antisepsis. It shows a vast advance over the conditions described above and is a valuable contribution to the history of American medicine. By the summer of 1876 the more progressive surgeons of this country were awakening to a knowledge of the new things. The idea of cleanliness had begun to assert itself and the generous use of "carbolic wash" to prevail. Greater care was bestowed upon the washing of instrume'nts and the destruction of soiled dressings. Sponges were still in vogue. But the hideously unclean methods of some of the European surgeons as to clothing, hands and instruments were by our advanced surgeons strongly discountenanced. Following the introduction of the use of solutions of carbolic acid came the news of Mr. Lister's theory of "free drainage." This was adopted at the Presbyterian Hospital during my term of residence by both Dr. Charles K. Briddon and Dr. Lewis A. Stimson, and many other ten96 tative departures from older methods were made by them and by other leading surgeons of New York, notably Drs. T. Gaillard Thomas, James R. Wood, Robert F. Weir, Frederick S. Dennis, Robert Abbe, William T. Bull and others. My own mind was greatly stirred. During my interneship at Charity Hospital, and at the Bellevue Clinics, abundant opportunity had been given for the observation of the former surgical methods as practiced by some of the less progressive of the older men. The longing for betterment was becoming insupportable. During the summer of my incumbency as Resident, a vigorous, healthy boy of fourteen, a newsboy on the Ninth Avenue Elevated Railroad, fell and was rolled between the platform of the station and the car of a moving train. He was brought to the Presbyterian Hospital with extensive fractures of the ribs, fracture of the pelvis and a lacerated wound of the knee which opened into the knee-joint. He came upon the service of one of our oldest surgeons. In examining the lad the Doctor, as was the custom of himself and of a few remaining contemporaries, insisted upon inserting his little finger, unwashed, into the cavity of the joint, in order, as the saying was, "to explore the wound.) He announced that he would amputate the leg the following day. This procedure seemed utterly wrong, because both unnecessary and dangerous. With the patient's other grave injuries immediate amputation of the leg or the occurrence of suppuration in the joint would be almost surely fatal. I therefore made strenuous objection both to the proposed examination of the interior of the joint and to the removal of the limb. Now, let it be known that the doctor was one of the oldest and most famous surgeons in the city. He had been physician to my own family for over thirty years. Indeed, on that May morning when I had first looked upon the light of day, his hand was the first to grasp mine in genial welcome. For a house officer to oppose the order of his superior under any circumstances is a serious offense. Situated as we were it was particularly so. But the case was desperate, the life a valuable one. I resolved to save the boy if possible, even at the risk of dismissal. Naturally the doctor was indignant. Our controversy ended by his giving up the case, throwing the responsibility of it upon me. The wound of the knee was apparently clean. I washed it carefully with carbolic solution, sealed it with a 97 collodion dressing and kept it at a low temperature by means of a cold water coil. Many complications arose from the fractured ribs and crushed pelvis, but they all subsided in time and the knee went on to complete recovery, without accident or incident of any kind. Fourteen years later this patient, then a well developed, vigorous man, was exhibited at a meeting of the New York Clinical Society. He was sound in wind and limb, with perfect action of the knee joint and was filling a useful place in life. I have related this case in order to suggest some of the conditions prevalent in the pre-Listerian days. Truly however it marked the dawn of a great tomorrow, for not many weeks after its admission there took place the most remarkable event that had occurred in the history of American surgery. In the month of August, 1876, a man was admitted to the service of Dr. L. A. Stimson, suffering from a neglected compound, comminuted fracture of the upper part of the tibia, caused by the kick of a horse. More than a week had passed since the injury, the wound was practically an abscess, filled with pus, spicules of bone and fragments of clothing, and the conditions were particularly foul and septic. Under the old conditions to close such a wound was unprecedented; only one result could have followed. The wound was cleansed as thoroughly as possible and its cavity packed with acetate of zinc. In spite of large opiates, the pain of this was terrific. After a certain length of time the zinc was removed and a Lister dressing applied, not, however, under the carbolic spray. My orders were, not to disturb the dressing unless the temperature went above a certain degree. For the greater part of the next three days and nights I stayed by that patient, with thermometer and scissors at hand, fervently hoping for the best but expecting the worst. The temperature remained at about 1000, nothing happened locally and the general condition improved. When at the end of three days, Dr. Stimson finally removed the dressing he disclosed to our amazement the first case treated in this country under the rules of Mr. Lister and that case a success. I can recall no such moment of ecstasy in all of my professional life. There, visibly demonstrated before us, was the triumphant proof that gone forever was the old regime of surgical uncleanness, infection and death. Not an instant was needed to calculate the unending possibilities of the new way. A 98 never to be forgotten vision, the memory of it has grown brighter with the lapse of time. Half a century has but intensified its first tremendous thrill. Glory to Pasteur and to Lister, its blessed promise has been realized far beyond the wildest flights of our first great enthusiasm. A few weeks after the date of the above case, Prof. Wm. H. Van Buren arrived from Europe bringing with him a complete original Lister outfit. This was at once placed in the hands of Dr. Stimson who operated early in October, 1876, at the Presbyterian Hospital. I was present and witnessed the operation. The case was one of amputation of the thigh. The operation was performed under the carbolic spray in strict conformity with the full details of the method and Lister dressings were used. The result of the case was a brilliant success. As far as I have been able to learn, this was the first complete Lister operation performed in America. Dr. Arthur M. Jacobus, a former interne, has presented to the hospital the original Lister apparatus used in the operation referred to above, carefully preserved since 1876. The method used for disinfecting our wards may be interesting. Everything was removed from the room. The floors were scrubbed, the windows closed and calked and the room saturated with steam. Basins containing salt were placed upon the floor in a row. Beginning with the one farthest from the door of exit hydrochloric acid was poured upon each one in rapid succession. There was an instantaneous evolution of chlorine gas which required some alertness on the part of the one using the acid to retire before being choked. The door was then closed and the room left for upwards of twenty-four hours. Probably few more effective methods exist today. 99 rJ, I'u' r C NURSING AND THE DEVELOPMENT OF THE TRAINING SCHOOL 4~': WILLIAM GILMAN THOMPSON, M. D. NURSING AND THE DEVELOPMIENT OF THE TRAINING SCHOOL At the time of my residence at the Presbyterian Hospital, 1876, the training school later established in 1894 had not yet been thought of. Already, however, Miss Abby Woolsey had published her pioneer wprk, "A Century of Nursing, with hints towards the organization of a Training School" and had been actively influential in the establishing of the Training School at Bellevue. Under the skillful direction of Miss Jane Woolsey a fairly efficient corps of nurses had been developed. While these w-omen were generally of plainer type and lacked the elaborate education of the scientifically trained nurse of today, Miss Woolsey had caused them to be thoroughly grounded in the fundamentals of their art. Some of them were well qualified by nature for the work. On the whole, their services were fairly satisfactory, in a few instances eminently so. The work of directing and supervising them was far greater than is called for today. But whatever may be said in favor of modern training, no nurse I have ever known excelled in skill, judgment, kindness and obedience the, for many years, head nurse and general guardian of the wards of the Presbyterian Hospital, Miss Rafferty. Of the many valuable legacies left to the hospital by Miss Woolsey, she was the first. She was an American of middle age, and of good family, and had gained her training and experience in nursing entirely from Miss Woolsey. She was highly intelligent in the performance of her duties, absolutely devoted to her work and most efficient and sympathetic in the execution of it. Best of all, she carried out the orders given to her with implicit fidelity and accuracy and with remarkable skill. These sterling qualities together with long experience under distinguished physicians and surgeons, more than compensated for any lack of so-called higher technical training. Well fitted by nature for the work, she was an ideal nurse and one of the best women that ever lived. This statement is attested by the fact that she held her position until the advancing gorowth of the hospital and her own failing strength caused her to abandon it. She retired after a lifetime of loyal service, bearing with her the deep respect and affection of all her associates. 103 No member of the staff of the Presbyterian Hospital ever deserved better of it than did Miss Rafferty. It would be no more than an act of simple justice if some permanent record of her could be established in the institution. In a few instances male nurses were found who had worked in the old New York Hospital or in other high class institutions, under eminent physicians. More often they were ignorant men of very ordinary type, or convalescent patients, untrained, inefficient and often unintelligent. This was especially true of those placed upon night duty-a custom common in the best hospitals of the time. The dawn of another epoch in New York City marked the birth of the Presbyterian Hospital, for then the system of training schools for nurses was inaugurated. The first of them in this country was established at Bellevue Hospital, May 1, 1873. This was followed soon after by one at the New York Hospital, under the directorship of Miss Eliza Watson Brown, a lady from Virginia, of fine family and liberal education. The Charity Hospital Training School was started August 1, 1875, during the time of my interneship in that institution, at the initiative of members of the State Charities Aid Association. The custom which had obtained in the City Hospitals of employing as nurses women from the Work House or other derelicts, with only now and then a really efficient and respectable person, was intolerable. The contrast between it and the new order at Charity Hospital was overwhelming. Few greater blessings have ever come to suffering humanity. Conditions in the private hospitals before training schools were established of course were vastly better than at the City Hospitals, and it is an open question whether the present undergraduate is as satisfactory an attendent as was the good, old-fashioned experienced nurse of fifty years ago. The conditions just described as existing during my residence at the Hospital in 1876 continued for the following decade, and while the history of that period is in advance of my story, the founding of the Training School for Nurses of the Presbyterian Hospital was an event of such importance and to the readers of this a matter of so great interest as to well deserve permanent record. With the departure of the Misses Woolsey the training of nurses practically ceased, except in so far as the good 104 Miss Rafferty could spare time and strength from her multifarious duties to impart something of the spirit of her own matchless instructresses, or the members of the Medical Staff could stop in the midst of their rounds to teach the ordinary simple rudiments of the art. In 1887, Dr. William Gilman Thompson was appointed Attending Physician to the Hospital. From him has been obtained the following brief account of the origin of the present training school, and of the conditions which urged the necessity for its existence. From his graphic description it will be realized that the same objectionable features which confronted me in 1876 had continued unchanged. On being appointed to the Visiting Staff of the Presbyterian Hospital I was much perturbed by the poor character of the nursing and the impossibility of finding from the nurses' records what had been the real condition of the patients during the temporary absences of the Medical Staff. In those days all male wards were cared for by socalled "orderlies," who were recruited from convalescent patients having no education or previous training. A sick Irish laborer, for example, would, during convalescence, watch the man who attended him and thinking he could do such an easy task, would apply for it as soon as he was able to walk about. These so-called "orderlies" were required to kepp a night report in a small note book, in which should have been recorded the condition of the patients during the night. Some of these reports were so remarkable that I have kept them until now, and quote some of their choicest statements. For instance, on the night of September 2nd, 1889, the sole report is: "All patients slept good most part of the night. Nothing extra to report." On June 1st: "There is nothing special to report this morning as all patients rested well." June 11th: "Everything quiet." On June 19th I read: "Rogers-I found him strolling through the ward on two occasions. He received Ward sleeping mixture at 11 and slept until 5." 105 On June 22nd: "Cassalo was very restless and kept groaning a good deal. All the other patients rested well." On June 23rd: "Rogers was noisy tonight, whenever I turned my back he was out of bed. The rest was quiet." August 3rd: "All the patients slept well except Schneider he coughed considerable." August 13th: "Anderson slept the entire time I remained on duty. All others slept well." September 3rd: "Foley did not sleep much. All the rest of the patients slept quite well." These notes in each instance constitute the sole night report for two wards which the night orderly was supposed simultaneously to serve. In each ward were many patients seriously ill with pneumonia, typhoid fever, and other complaints. The unanimity with which they were recorded as having "slept well" greatly interested me, and I began to suspect that the person who had done most of the sleeping was the orderly. I so intimated to him and suggested that he make some slight variation in the monotony of his reports, which he very obligingly did. He was a jovial Irishman by the name of John Lee. Shortly after I received the following memoranda: "C........ had a splendid nights rest, in fact it was the best night he had experienced since he came here. All the other patients slept massive." Two nights later I read: "There is nothing special to report this morning as all the patients slept well and C........ slept like a young goat." This Italian patient, C........, seems to have attracted particular interest. For a few nights later it is recorded: "C........ slept well, but he kept shouting and whistling in that state, otherwise he was very quiet as he made no attempt to wander through the ward. All the other patients slept well." (Showing remarkable equipoise on their part!) 106 A climax was reached when I received the report: "Schneider died at 4:10 A. IM. All others done well." Armed with these lucid reports, I went before the Executive Committee of the Board of Managers and told them that I understood they held the Medical Board responsible for the entire conduct of the service, but that I must decline to accept responsibility for what went on in my wards during my absence at night, and I read them these reports. They were, I must admit, considerably surprised and asked what they should do about it. I suggested that in several other hospitals so-called training schools for nurses had been established and were proving increasingly successful and valuable, and I thought the one thing to do was to establish such a school at the Presbyterian Hospital and replace the orderlies in the men's wards by trained women nurses. This suggested innovation provoked considerable discussion, but on the 11th of October 1890, a year later, the late 1Mr. John S. Kennedy, then President of the H-ospital, wrote me as follows: "As soon as the new buildings are completed, I hope we shall have a training school for nurses. I intend that the Presbyterian shall be the best hospital in every respect in this city and in this country, and I am sure that you and the other members of the Medical Board will do everything in your power to make it so." Shortly afterward it was learned that there was a young woman in the Massachusetts General Hospital who had already given great promise in teaching nurses and developing the training school system, and she thereupon was invited to come to the Presbyterian Hospital and open its school for nurses. In order fully to appreciate the magnitude of the work which Miss Maxwell has accomplished in the field of nursing, it is interesting to know something of the difficulties which beset her early endeavors, and they are well illustrated by these memoranda which show the chaotic conditions amid which she first undertook her great work in this city. With the advent of Miss Maxwell, the Presbyterian 107 1SP.1 a1 (1) bf)) ct Po 1SP.1 a1 (1) bf)) ct Po ANNA CAROLINE MAXWELL ANNA CAROLINE MAXWELL, R.N., A.M. ANNA CAROLINE MAXWELL, R. N., A. M. The inauguration of the Training School for Nurses was a fundamental event in the progress of the Presbyterian Hospital. The memory of the spirit of the first directress lingered in the minds of the older members of the Board; their own high ideals and generous purposes had been recognized by Miss Woolsey and carried by her into successful execution. Dissatisfied with the conditions which existed after her time, they welcomed the better things promised by the new order and exerted themselves to institute the Training School and select for it the best possible head. In this they were again fortunate, for their choice fell upon Miss Maxwell who, with more than ten years of unusual experience as director of nursing in two of the finest hospitals in the world, had demonstrated the possession of pre-eminent ability. It is a fact of significance that the most distinguished directresses of the leading training schools of New York during the last fifty years have been of direct American descent: Miss Van Rensselaer of Bellevue, Miss Eliza Watson Brown, Miss Irene Sutliffe, and Miss Anne Goodrich of the New York Hospital, the latter now Professor of Nursing at Yale; Miss Van Kirk of Mount Sinai; and finally, Miss Maxwell-all natives, and nearly all of New York. Miss Anna Caroline Maxwell, R. N., MT. A., was born in Bristol, Northern New York, March 14, 1852. Her father, a clergyman, by whom she was educated, was of Scotch descent, as was her mother. An ancestor of her father had been Governor-General of Newfoundland. In October, 1878, she entered the Boston City Hospital as student nurse, graduating in 1880. In that year she went to Montreal to organize a school of nursing, remaining there for six months; but the effort to establish this school was premature and it was not until ten years later that an attempt was again made, this time with success. From Montreal Miss Maxwell was called to the Directorship of Nursing in the Massachusetts General Hospital, Boston, which position she filled with great credit from 1881 to 1889. In 1889, she was called to New York and made Director of the Training School at St. Luke's Hospital. In January, 113 1892, she was invited to become the head of the new enterprise at the Presbyterian Hospital. 'The invitation was accepted and the work of its organization at once undertaken. This was soon accomplished, upon a basis which attracted wide attention, Miss Maxwell's superior ability already having been well recognized. Under her management the school was placed upon the highest grade of excellence, as to the character, fitness, and education of its candidates. Miss Maxwell herself was not only thoroughly versed in the most advanced ideas of hospital training but made no small number of contributions of her own. Many of the methods and appliances in nursing which are most approved today originated with and were introduced by her. Like Florence Nightingale and Miss Woolsey, she taught the spirit of universal kindness and consideration to all patients alike, and that refinement in the nurse is no less essential than efficiency. The recognition of the pre-eminent excellence of her graduates soon found its way beyond the limits of the institution, and the school became famous. Miss Maxwell retired from duty July 1st, 1921, thus completing an active service of nearly thirty years, the longest and by far the most distinguished of any of its kind in the United States. Under her administration the chaos of former days vanished and an organization of unrivalled excellence was created; an institution which for many years has held undisputed leadership, whose pupils, sought for as the heads of other institutions, have carried the principles of their splendid training throughout the land. At present the Training School of the Presbyterian Hospital, under the able directorship of Miss Helen Young, numbers about 145 pupils for complete service, exclusive of about thirty probationers. By no means all of these are available for the work of the Hospital itself, as from this total must be supplied the affiliations for the senior students -The Sloane HLospital for Women, The Manhattan Maternity Dispensary and the Nursery and Childs Hospital. On the evening of February 1st, 1922, a dinner was given Miss Maxwell by the friends and the graduates of the Training School, in the large ball room of the Biltmore Hotel. More than five hundred were present. The Committee, headed by Miss Louisa Lee Schuyler as Honorary Chairman, and Dr. John H. Finley as Chairman, contained the names of 144 of the most distinguished educational and philanthropic leaders of the city. Dr. Finley presided, and 114 the speakers were Miss Adelaide Nutting, Dr. George F. Brewer, Mrs. August Belmont, Dr. Haven Emerson, Miss Lillian D. Wald, and Miss Anne W. Goodrich. Going up in the elevator early in the evening were two gentlemen, evidently residents of the hotel, who were discussing the size and character of the gathering in the lobby. Said one to the other: "Who and what are these people?" "I don't know," replied his friend, "but they are certainly the finest looking lot of young women I have ever seen in this place." Thus the graduates of the Presbyterian Hospital impressed a casual and entirely disinterested observer. iSeated at a point from which the whole brilliant scene of the dinner party could be studied, my mind wandered backward to my own days in the hospital, when Miss Woolsey had gone, Miss Maxwell had not yet come, and the only connecting link between them was the good Miss Rafferty. Tempora mutantur! Now the graduates of the school number over one thousand! 115 1SP.1 a1 (1) bf)) ct Po 1SP.1 a1 (1) bf)) ct Po JANE STUART WOOLSEY ABBY HOWLAND WOOLSEY The influence of the Misses Jane and Abby Woolsey upon the development of the Presbyterian Hospital and the establishing in it the high standards which characterized its early days renders their connection with the institution an important feature of its history; while their own extraordinary careers are too inspiring to be forgolten. The family to which they belonged and of which they were such worthy members is one of the oldest and most substantial in this country. George Woolsey, the first member to arrive here, came from Yarmouth, England, in 1623 -24, and settled, with the first comers, in New Amsterdam. He removed to Jamaica, Long Island, about 1664. Charles William Woolsey, his direct descendant, married Jane Eliza Newton, a descendant of John Newton of Hull, England, who came to America about 1666, and settled in Virginia. They were the parents of Abby, Jane, Georgiana and Eliza Woolsey, besides other children. Miss Jane Stuart Woolsey, in whom we are particularly interested, was born in 1830. In 1840 the family came to New York where Jane received her early education, first at the Rutgers Female Institute, then located at Rutgers Place, and later at the Bolton Priory, Pelham, both famous schools for young ladies. On the breaking out of the Civil War the Woolsey family devoted themselves heart and soul to the service of their country. In April, 1861, the Woman's Central Association of Relief, lafterwards part of the Sanitary Commission, was 'The Woman's Central Association for Relief was formed for the purpose of collecting supplies, furnishing nurses, and otherwise rendering needed weltare service in ways not regularly provided for by the Government. It was the precursor of the United States Sanitary Commission, that great organized volunteer agency which in turn was the predecessor in this country of the Red Cross Society, through which, outside of the Government, individuals wrought for the good of the army. The plan of the Cominission came from a distinguished clergyman, Rev. Henry W. Bellows, but the impulse which underlay the thought was given by the women of the north at the commencement of the Civil War. Among those most interested were the two Black119 formed, and the Woolsey sisters worked with it. Meanwhile, a nursing staff for the army was being assembled. One hundred women, including the Woolseys, were selected and sent to various hospitals in New York City, for such instruction as could be secured in a few weeks through the aid of physicians of the hospital staffs. The Misses Woolsey worked at the City Hospital, the Park Barracks, a temporary hospital in City Hall Park, and at other places. In 1862, Miss Jane Woolsey, who had been conected with organizations in New York for receiving disabled volunteers on their way home, wrote "helpless, wasted, gaunt, fever-smitten, wornout men; we do what we can for them, but it is heart-breaking work." How many of those who read this, will recall their own experiences of the late war! In May, 1862, the Misses Woolsey offered their services, and were accepted on account of the immediate necessity for more nurses. They were placed on twelvehour day duty in the hospitals, the night service being taken by paid male nurses. In September, 1862, SurgeonGeneral Hammond requested Miss Wormeley to take the Lady Directorship of the Portsmouth Grove Government Hospital near Newport, Rhode Island. Miss Jane and Miss Georgiana Woolsey joined her there and remained in that service for about five months. In August, 1863, the two sisters, Jane and Georgiana, requested to be transferred to the new and fine General Hospital near Washington. They had already promised to go to the Hammond Hospital at Port Lookout, Maryland, a regular army hospital, but this had hardly been established when orders came to turn it into a camp for Confederate prisoners. They then went to the large Barrack Hospital in Fairfax, Virginia, where Miss Jane Woolsey stayed until the close of the war. About this time the "Freedman's Institute" was organized at Hampton, Virginia, by a group of northwell sisters, LEmily and Elizabeth. They had been the first women to enter the profession of medicine and at that time were successfully conducting the Infirmary for Women in Second Avenue. At first the Drs. Blackwell and afterwards Mrs. Wm. Preston Griffin undertook to find and train nurses for the army. There being no training schools in existence and the need being very urgent, the Committee could only provide a single month's training of the most elementary kind in hospital wards for those women who offered their services. From several hundred candidates, one hundred were selected "suited in all respects to become nurses." However hazardous the entrusting of wounded men to nurses so inadequately trained may seem to us, many of them developed great proficiency and made their services of inestimable value. 120 ern philanthropists, under the leadership of General Armstrong. Miss Jane Woolsey identified herself.with this work, assisting in the organization of the Institute and in the conduct of its affairs. Her connection with Hampton was ended just prior to her appointment in 1872 to the Superintendency of the Presbyterian Hospital. Immediately after the war the Government organized the Freedman's Bureau for the care of the freed slaves, and volunteer agencies were at once active in aiding the officials. Miss Jane Woolsey volunteered her services and opened in Richmond a school called the Lincoln Industrial School for Colored Women, where clothing of all sorts was cut out and made under her direction, and sold at low prices to poor whites or blacks, or to any one else who would buy. About 1868 she took charge of the Industrial Department of the Hampton Normal and Agricultural Institute for colored women, then recently organized by General Armstrong. Four years later, she received the following significant letter from Miss Louisa Lee Schuyler, who was at that time organizing the Training School for Nurses at Bellevue Hospital, New York. "I have heard from several sources that a proposition has been made to you from the Lenox Hospital. If, my dear Miss Woolsey, you are considering any such proposal, will you not also consider one in connection with the Lady Superintendent for our Training School for Nurses?" Miss Woolsey accepted the other invitation and was appointed Resident Directress to the Presbyterian Hospital October 16th, 1872, as is shown from a letter dated September, 1873, in which she says: "The summer has been a hard one, from the heavy weather and because of patients at the Hosptal having increased between thirty to forty per cent. in the last three or four months." In the directorship of the Presbyterian Hospital Miss Jane Woolsey was ably assisted by her sister, Miss Abby Howland Woolsey, as Acting Clerk of the Hospital and at times as Executive Officer. Miss Abby Woolsey was one of the original members and always an active manager of the State Charities Aid Association. For twenty years she was a member of its committee on Hospitals and for more than a decade a member of the Board of Managers and the very efficient librarian of the Association. One of its most gifted members, Miss Abby Woolsey's power of organization and executive ability were early called upon from 1872 to 1875 in behalf of the Bellevue Hospital Train121 ing School for Nurses, in which work she renderd most efficient service. She also served at different times upon committees for the Insane, for preparing plans for hospital construction, and so forth. Indeed, there was scarcely a department of the hospital committee of the State Charities Aid Association in which her knowledge of the subject and conscientious work were not felt. The four sisters of the Woolsey family were distinguished not only as patriots, in company with thousands of others, but for their unusual powers of organization and of executive ability, united with rare literary talent, as shown in their letters and their publications. A collection of their works to the number of about twenty, mostly written during the Civil War, was presented to the State Charities Aid Association, and is now deposited with the Library of the Russell Sage Foundation. Among them may be mentioned "Three Weeks at Gettysburg," by Georgiana Woolsey, a graphic account of work done by herself and her sister, Miss Eliza Woolsey, (afterwards the wife of Joseph Howland, brevetted Brigadier General, for heroism on the field of Gaines' Mills, Va.,) for the wounded at the front after that great battle, in which we lost 24,000, the Confederates, 30,000-altogether more than one-third of all the forces engaged. I personally visited Gettysburg a few weeks after the battle, and, although a child, vividly remember the camp hospital-row after row of large army tents, laid in regular order, with spaces between for streets. Miss Woolsey says: "About 20,000 men came from the battle to us, and I saw but very few who were but slightly hurt among the wounded. We fed all of the 16,000 who went away." At the time of my own visit, as many as possible of the wounded were being removed, principally to Washington. One of the railroad coaches used for this purpose was a large baggage car in which uprights had been fixed the whole length of the car and on both sides. From the uprights, ordinary field stretchers were hung, supported by strong india-rubber bands-a device frequently used since. I remember also a slice of the bread furnished to the patients, which was handed me by one of them, and which I found upon biting to be full of fine white sand. "There, sonny," said this fine-looking young officer, "put your white teeth through that, and tell the folks at home what the contractors are feeding us wounded soldiers!" 122 Miss Abby Woolsey was the author of the ablest and most valued publications of her time on the subject of trained nursing. "A Century of Nursing, with hints toward the organization of a Training School," published in 1876, "Lunacy Legislation in England," published in 1884, were justly regarded as masterly treatises. They show extensive research, historical accuracy and a presentation of the subject at once clear and forcible, united with an elegance of diction which characterized all of her literary work and that of her sisters. "Hospital Laundries" was published in 1880, but not until after the "Handbook for Hospital Visitors" had appeared in 1877. This well-known handbook was pronounced by competent authorities in this country and in England to be the best work of its kind in existence and is still in use. "Hospital Days," by MIiss Jane Stuart Woolsey, should be reprinted. It gives a remarkable account of the conditions in Northern hospitals and on transports during the Civil War and it presents a record of hard and indispensable service well and bravely done; but how curiously naive and undisciplined the art of nursing was appears on every page. "Hospital Days" was published anonymously but in an editorial which appeared in the New York Evening Post of May 30, 1893, the writer said: "There is now no harm in giving the name of the authoress, Miss Tane Stuart Woolsey. No such interesting reminiscence of the pathetic side of active service exists in American literature, for no other observer had Miss Woolsey's keen perception, in combination with great literary power. The preface is one of the most perfect bits of English prose within our knowledge, and in the quality of tender grace may well be placed beside the epilogue with which Cardinal Newman closes the Apologia." We quote it entire: "In the autumn of 1865, when the new peace on all the hills and fields made them seem so sweet and fair, we found ourselves, a family long parted, exploring the by-roads in the North New Hampshire country. Following one day a winding green wagon track far from the main road, we came upon a desolate rough farm half way up the lower slope of the Bartlett Mountain. A dozen sheep were scattered over the stony field and among them sat a man in the full uniform of the Zouave, bagging trousers, gay braided jacket, cap, tassel and long bright crimson scarf complete. He had just got home from some distant post, with very little back pay in his pocket for the sick wife, and none at 123 all to spend in sober clothes and had gone at once to work upon the obstinate farm, all in his gay attire. He seemed a little stunned by the silence around him; "he missed the drums," he said. We had a little talk over the old days, already so distant although so near, and left him, the sun touching the red and blue of his bright garments, tending the sheep under the solemn hills. "ONE WHO SITS AND LISTENS FOR THE DRUMS TODAY SEEMS LIKE THE ZOUAVE AMONG THE SHEEP CROFTS; THE FLAGS AND THE MUSIC HAVE MARCHED SO FAR AWAY; AND YET THERE MAY BE SOME IN THESE TIMES OF GAIN GETTING, PLEASURE SEEKING, AND REACTION, WHO ARE NOT SORRY TO LOOK BACKWARD A LITTLE NOW AND THEN, AND REFRESH FROM THE OLD FOUNTAIN THEIR COURAGE AND THEIR LOVE OF COUNTRY." 124 GREAT MEN OF THE PRESBYTERIAN HOSPITAL GREAT MEN OF THE PRESBYTERIAN HOSPITAL Having considered the spirit which inspired Mr. James Lenox and his associates in the founding of the Presbyterian Hospital, and having given a somewhat intimate account of the institution during the first four or five years of its history the story would be incomplete without some reference to the brilliant group of physicians who composed its original Medical Board. The selection of these gentlemen was effected by Mr. Lenox mainly through the counsel of his friend and physician, Dr. Oliver White, aided by Dr. Willard Parker, whose influence in the selection also of the Attending Staff was strongly felt. As originally organized in 1871, the Consulting Staff consisted of Dr. Alonzo Clark, Dr. Oliver White, Dr. George A. Peters, and Dr. John J. Crane. Drs. Clark, Peters and Crane were replaced in 1876 by Dr. Jared Linsly, Dr. Gurdon Buck, Dr. William H. Van Buren and Dr. William Detmold. All these gentlemen were prominent and influential physicians. Several were men of the highest distinction, notably Dr. Gurdon Buck. The Presbyterian Hospital appealed to them as an institution of great promise, to which they were glad to lend the dignity of their names and render the support of their active interest. From the beginning of the Hospital's existence the acknowledged superiority of its Medical Staff challenged the attention and the respect of the community. It is right, therefore, that the memory of the characters and the careers of those composing it should be perpetuated and permanently remembered in the history of the Hospital. Moreover, the story of their lives is replete with suggestions to those who, two generations later, find themselves in the midst of times, manners, and men in many ways so different. Notwithstanding these differences, many of them radical and some of them startling, it must appear that the same principles of integrity, intelligence, thorough preparation and indomitable industry are as essential to success with us as they were with our fathers. In the possession of these qualities the consultants of the Presbyterian Hospital were notable examples. The fact that they represented the best element of the good original American stock is also significant. While all of them were men of distinction it is 127 right that those should be first considered who were earliest and most intimately associated with the organization of the Hospital. In this series of sketches I have drawn upon the statistical material presented in Dr. Howard Kelly's "Biography of American Medicine." To this has been added information and observations of my own, in many cases gained through long continued and more or less intimate contact. These old doctors were men who had not, through the introduction of modern diagnostic aids, lost to a considerable degree the natural powers of observation and the full utilization of the natural senses; nor had the introduction of anaesthesia yet caused the marvelous dexterity and quickness of the skilled Masters of Surgery to have become a lost art. There were great men among the physicians of our city fifty years ago. The Presbyterian Hospital enjoyed a generous share of them. The secret of their greatness is revealed in the story of their lives. All were men of the good, old fashioned early training, who recognized that the path to success, requiring the most thorough groundwork of preparation, led through difficult places but who nevertheless, had the energy, courage and patience to persevere against all obstacles and, with the high character, intelligence and faith that was in them, to attain the greatest possibilities of usefulness. Nothing could more eloquently represent them than the accompanying presentations of their own countenances, grand and serious from the long battle against the ills and sufferings of mankind but beautified by that strong love of humanity which, originally urging them into the profession of medicine, had until the end inspired their lives. 128 OLIVER WHITE OLIVER WHITE, M.D. OLIVER WHITE, M.D. Dr. Oliver White was born in Somers, Westchester County, New York, April 9, 1810. It has often been observed that the spirit of the true physician is inherited. Oliver White was in a remarkable degree born to the profession. While other instances of the kind have not been infrequent, the story of his family is particularly noteworthy. His first ancestor to reach this country came over in the "Mayflower" as a member of the Plymouth Colony, and was father of Perigrine White, the first child born after the Pilgrims' landing. Dr. Oliver White was not descended from Perigrine but from another son of the same family. Hi's grandfather, Ebenezer White, had five sons, three of whom were physicians. These were Ebenezer White, Jr., of Somers; Harry 'White, of Yorktown, N. Y., and Bartow White, of Fishkill Village, Putnam County, N. Y. Lewis and Theodosius were farmers. Ebenezer, Jr., married Amy Green, daughter of an old and highly respected family of the English colony of Connecticut, settled in 1641. The couple made their home in Somers, Westchester County, N. Y., then as today, nestled among verdant hills, a charming type of the quiet, peaceful English village. Ten children were born to them, seven sons and three daughters. Two of the sons died in infancy. Of the remaining five, three became physicians-Bartow White, of Yorktown; Lewis Howell White, of Fishkill, and Oliver 'White of New York. Lewis succeeded to the practice of his uncle, Bartow White, of Fishkill, who retired after a service of forty years, in which he distinguished himself as an able physician and an influential member of his community, then composed of some of the best families in the state. The career of Lewis White was well worthy of his predecessor. Beloved and esteemed wherever known, his sturdy integrity, warmly sympathetic nature, and practical wisdom as a physician made him at once the trusted guardian and the oracle of the place. Like his predecessor, he spent his life in an active practice of more than forty years. He was succeeded by his son, the late Dr. Lewis Howell White, who, ably maintaining the traditions of his family and serving an equal length of time in Fishkill, the village of his birth, died about four years ago. Thus 131 was rounded out the remarkable incident of a continuous service of medical practice by one family, in the same location, of more than one hundred and twenty years. Such were the antecedents and the associations of Oliver White. The medical instinct was his by strong inheritance. Also, like his predecessors, he was an able adviser in general affairs. Brought up under the example and precept of his father he came to New York early in his career and acquired an excellent practice among the best families of his neighborhood, finally purchasing a residence at No. 52 West 12th Street, and becoming the physician of the Lenox family, his near neighbors. Mr. James Lenox soon discovered in Dr. White a man of great honesty of purpose, soundness of judgment, and excellent foresight,-one highly sympathetic with his own views and anxious to lend every aid in their execution. He extended to him his fullest confidence, and from the outset consulted him intimately in all the details of the plans and the organization of the Hospital. Although not as distinguished professionally as some of his fellow members of the Consulting Staff, it was natural that when the staff was finally organized he should have been given a place upon it. In the selection of the Staff Mr. Lenox relied largely upon Dr. White and Dr. Parker. Although Dr. Parker himself was unable to accept a place upon the Medical Board he was the one medical representative upon the original Board of Managers, appointed in 1868. His influence upon the selection of the Medical Board, with that of Dr. White, was greater than that of any other. The important part which Dr. White played in the organization of the Presbyterian Hospital was justly regarded by himself and friends as the most notable achievement of his life. He was also actively interested in the development of the New York Academy of Medicine and at the time when the Academy secured its first building was chairman of its Board of Trustees. Through an inter-marriage he and his family were known to me from my infancy and it was by him that my connection with the Hospital was suggested. He died of apoplexy, at his home in New York City, November 7th, 1879. 132 WILLARD PARKER WILLARD PARKER, M.D., LL.D. WILLARD PARKER, M.D., LL.D. Dr. Willard Parker was born at North Lyndeborough, Southern New Hampshire, in 1800. When he was five years old his parents moved to Chelmsford, Massachusetts, where his ancestors had settled early in 1600. There the boy worked on the farm, taught school, and with his own earnings paid his way to and through Harvard College, graduating in 1826. It is said that he had intended to study for the ministry but was so impressed with the skill of Dr. John C. Warren, who diagnosed and reduced a strangulated hernia in young Parker's roommate, that he decided to study medicine. He secured an appointment as interne at the Marine Hospital in Chelsea, receiving $13.00 a month during his two years of service. He received the degree of M.D. from Harvard in 1830, and began the teaching of surgery at once, holding the following appointmentts: Professor of Anatomy and Surgery, Colby University, Maine, 1830-33; Professor of Surgery, Berkshire Medical Institution, 1833-36; Professor of Anatomy, Geneva, N. Y., 1834-36; Professor of Surgery, Cincinnati, 1836-37; Professor of the Principles and Practice of Surgery, College of Physicians and Surgeons, New York, 1839-69. In 1856 Dr. Parker was appointed Surgeon to the New York Hospital. As an* operator he was skillful and successful. He was ambidextrous and possessed of keen eyesight. He originated the operation of cystotomy for irritable bladder, first done in Bellevue Hospital, in 1850. His most important contribution to surgery was his recognition of typhlitis and his operation for its relief. This was the precurser of the modern surgery of the appendix. As a lecturer, he had the faculty of selecting the important details and of successfully impressing them by means of apt illustrations. His personal presence was fine, his manner courteous and affable. He loved to teach. Lyman Abbott said of him: "He was an earnest Christian man and as much interested in preserving health as in curing disease. In this respect he was in advance of his time. He impressed me with the truth that the laws of health are as much the laws of God as are the commandments, and that it is as truly a sin to violate the laws of health 135 as to violate the ten commandments." His work for public hygiene and for temperance was untiring. He became Emeritus Professor in the College of Physicians and Surgeons in 1870, and received the degree of LL.D. from Princeton in that year. He was President of the New York Academy of Medicine in 1856, for many years an active member of the Pathological Society, and Consultant to St. Luke's, Roosevelt, Mount Sinai and other hospitals. The Willard Parker Hospital was named in his honor, in view of the efforts he had made to secure such an institution for the care of young patients suffering from diphtheria and scarlet fever. Public spirited in the broadest sense he was an extensive reader and collected a large library. In taking up the study of medicine I entered the office of Dr. Parker as a special student, at the suggestion of Dr. Edmund R. Peaslee, matriculating at the same time at the College of Physicians and Surgeons. All my life. I had heard of him as one of the greatest men of hi's time. My expectations were more than realized. Tall, well-proportioned and of commanding presence, with a countenance handsome, intelligent and strong, he impressed one as representing the embodiment of perfect manhood. His presence was an inspiration, whether in the sick room, at the operating table, or on the platform. With a keen sense of responsibility to mankind at large he was a born leader. The influence which he exerted outside the medical profession was widespread and useful. As an early advocate of temperance reform, he was earnest and practical, as shown by him in the organizing of the Asylum for Inebriates at Binghamton, N. Y. To us, his students, who were expected to spend much time at his residence and offices at 41 East Twelfth Street, he was the ideal preceptor, interesting himself in every phase of our welfare and stimulating us by well directed precept and, far more eloquently, by his own fine example of energy, truthfulness and skill. He never failed to impress upon us the necessity for a broad and thorough education in general medicine, emphasizing his remarks by saying "While I have the reputation of being a surgeon I am, first and before all, a physician." It would be well if those proposing to enter special departments of practice should take this dictum seriously to heart. Occasionally, when possible, he would admit one of us to his private consultations, in order 136 to impress some important principle in examination or diagnosis. His interest in and helpfulness to young men was one of his best known traits. A considerable group of the most successful practitioners of the generation which followed him owed their advancement to his early recognition of their ability and his substantial aid in their attainment of commanding positions. Broad-minded, discerning and experienced, it seemed that no one could have been better qualified to assist in the organization of the new Hospital. For several years I was one of his student assistants at his weekly Surgical Clinic at the College of Physicians and Surgeons and now and then was invited to assist at some operation in his private practice. He demanded perfect service, but in such a manner as to make that service a desirable privilege. The association with him has proved the most important influence of my professional career. He died at his home, No. 41 East Twelfth Street, New York, April 25, 1882. 137 ALONZO CLARK ALONZO CLARK, M.D., LL.D. ALONZO CLARK, M.D., LL.D. Dr. Alonzo Clark was born in 1807 in Chester, Vermont, a village founded by his father, Spencer Clark, of English descent. He was educated at the village school in Worthington, the Hopkins Academy at Hadley, Mass., and graduated from Williams College in 1828. Having secured a sufficient sum of money by teaching, he came to New York, entered the College of Physicians and Surgeons, and graduated in 1835. He then studied in London and Paris, later taking up his residence in New York. He had specialized upon pathology and the microscope, the latter not yet having come into general use in this country. Always a diligent student, he zealously utilized his opportunities in the wards and dead-house of Bellevue Hospital, and soon acquired a power of diagnosis and a knowledge of morbid processes which caused him to become a widely recognized authority. As a lecturer, his knowledge of his subject, his scholarly methods, his fine diction and his genial wit commanded attention and respect. Several of his contributions to medicine were of serious importance. Collaborating with Dr. G. P. Camman, of New York, the inventor of the modern stethoscope, important additions were made to the principle of percussion, verification being made upon the cadaver. Dr. Clark greatly improved the management of typhus fever by insisting upon a maximum of fresh air and cleanliness in his wards at Bellevue. One of the greatest advances of the time was his suggestion of the opium treatment of acute peritonitis. In this disease he discarded venesection, leeches, and mercurials, and maintained that a kind of saturation of the system with opium would be inconsistent with the progress of the inflammation and would subdue it. Dr. Clark held the Professorships of Materia Medica at the Berkshire Medical Institution, 1843-54, and of the Theory and Practice of Medicine at Woodstock, Vt., for thirteen years; the Chair of Physiology and Pathology, College of Physicians and Surgeons, New York, 1848-1855, and of the Theory and Practice of Medicine, 1855-1885 in the same institution, where he was also Dean and President of the Faculty from 1875 to 1885. He was Visiting 141 Physician to Bellevue Hospital, President of the New York State Medical Society, Member of the New York Pathological Society, and of the New York Academy of Medicine. He received the degree of LL.D from Dartmouth in 1853. My personal association with Dr. Clark seldom extended beyond the lecture room, where he commanded our profound respect. His personal appearance was impressive and dignified. His splendidly formed head and lionlike countenance were highly suggestive of Gladstone. Beneath a manner of great seriousness there was concealed a humorous spirit, ever ready on appropriate occasions to display itself. He was a lover of astronomy, a deep thinker, and a sound philosopher. He never married, but devoted his life absolutely to the work of his profession. 142 JARED LINDSLY JARED LINSLY, M.D. JARED LINSLY, M.D. Dr. Linsly was born at North Branford, Connecticut, in 1803. His father and mother were natives of the same place. There he died in 1887. His earliest ancestor in America was John Linsly, formerly a resident of London, and a member of the colony that founded New Haven about 1640. Noah Linsly, an uncle of Dr. Linsly, graduated from Yale College in 1791. He died in 1814, leaving in his will a bequest to Yale for the general purposes of the Institution. This endowment was increased by Dr. Linsly and is designated in the "Noah and Jared Linsly Fund." The income is now applied to the purchase of books for the Department of Foreign Languages in the University Library. It is said that young Linsly was a delicate boy and not having the requisite strength to labor on his father's farm acquired a fondness for books and it was decided that he should prepare for college. He was admitted to Yale in 1821 but by reason of his delicate health did not graduate until 1826. Without fortune or influence, but with strong faith and ingrained habits of industry, and with a mind well trained at home and at college, he moved to New York in 1827 and began the study of medicine in the office of that eminent physician, the late Dr. John C. Cheesman, at the same time entering the College of Physicians and Surgeons, from which institution he received the degree of doctor of medicine in 1829. He next served as interne for two years in. the surgical department of the New York Hospital. During the epidemic of cholera in 1832 he was physician to one of the cholera hospitals. Dr. Linsly formed an eligible partnership with Dr. William Minor, and two years later allied himself with Dr. William Baldwin, continuing with the latter until Dr. Baldwin's death. HIe located himself in Harmon Street, now East Broadway, at that time an excellent residential district. There he acquired a fine practice and in 1834 married Miss Catherine Fisher Baldwin, daughter of his partner. Their family consisted of nine children, five sons and four daughters, six of whom survived. In 1853 he removed to Lafayette Place, the center of the fashionable life of the city. In the same year, 1853, he and his wife were the guests of his life-long friend, Commodore Cornelius Vanderbilt, on 145 his yacht the "North Star," upon a trip from New York to England, Russia and the Mediterranean. A marked feature of his character was his great sympathy for young men in their struggles for eminence and he often aided them freely from his income and by commending them to the patronage of valuable friends and acquaintances. He was social in his habits, good company, full of anecdote, poetry and history, and an excellent conversationalist. He preserved with loving fondness the associations of his childhood and the recollections of his college life and as a busy man was ever living over and rejoicing in them. His practice was extensive among the best families of the city and his labors were continued until within two or three years of his death. 146 GURDON BUCK GURDON BUCK, M.D., LL.D. GURDON BUCK, M.D., LL.D. Dr. Gurdon Buck was born in Fulton Street, New York, in 1807. He was the son of Gurdon Buck, a merchant of the city, and of Suzannah Manwaring. Both were grandchildren of Governor Gurdon. Saltonstall, of Connecticut. Several other distinguished families of New England were in the line of their ancestry. Dr. Buck's early medical education was had in New York City. Under the preceptorship of Dr. Thomas Cock he entered the College of Physicians and Surgeons, receiving the degree of Doctor of Medicine in 1830. After passing the regular term of service as interne on the medical side of the New York Hospital, he continued his studies in Paris, Berlin and Vienna for a period of about two years and a half. In 1836 he again visited Europe, spending most of the time in Geneva, where he married the daughter of the chief magistrate of the city to whom he had presented a warm letter of introduction. Returning to New York in 1837 he was appointed Visiting Surgeon to the New York Hospital. This position he continued to hold up to the time of his death. He was also appointed Visiting Surgeon to St. Luke's and to the Presbyterian Hospitals at the time of the reorganization of those institutions. He was also Visiting Surgeon to the New York Eye and Ear Infirmary, from 1852 to 1862. He was a Fellow of the New York Academy of Medicine from its organization, and one of its Vice-Presidents; a member and one of the Presidents of the New York Pathological Society; a member of the County and State Societies, and of various societies abroad, where his genius was appreciated even better than at home. As a surgeon Dr. Buck was remarkable for boldness in operating and thoroughness of detail in after treatment. The patient study of his cases was one of his peculiar traits. Fractures especially interested him, and as a result of his painstaking care he was enabled to revolutionize the prevailing methods of treatment and to make improvements in the apparatus then in use which are matters of surgical history. His method of treating fractures of the thigh by the weight and pulley was at once recognized throughout the world as the establishment of an original principle of great value, and to this day is known as "Buck's 149 extension." His investigations with regard to the pelvic fascia were valuable icontributions to our knowledge of anatomy. His joint surgery was especially noteworthy in a pre-antiseptic era, for he successfully excised the elbow and the knee joints. He wrote much about abscesses of the right iliac fossa, and although not clearly understanding their cause definitely prepared the way for the recognition of appendicitis. He was deeply interested in rhinoplastic operations and most original and skillful in their execution. His book upon the subject is valuable today. Proficient in the surgery of other parts of the body, Dr. Buck again gained distinction by his contributions to the surgery of the larynx, and this prior to the invention of the laryngoscope. He introduced various modifications and improvements in the performance of tracheotomy; he performed' laryngo-fissure for the removal of laryngeal growths. His most important contribution was the discovery of the condition knowAn as "edema of the glottis" and the demonstration of efficient means for its relief. By palpation with the finger tip he recognized the presence and location of the swollen tissues. Then, with a special knife of his own invention, safely guided and protected by the finger and passed down to the top of the larynx, the infiltrated tissues were incised and drained and thus the swelling overcome. Dr. Buck attained great skill in the performance-of this feat and succeeded in applying it successfully to the saving of many lives. His teachings were quickly accepted here as well as abroad, where he was justly acclaimed "the Father of Intra-laryngeal Surgery." This was about the year 1848, long before the laryngoscope became known. He was also proficient in operations upon the bladder. Indeed, there were few departments of the surgery of his time in which he did not excel and upon which he has not left the impress of his name. For the contributions made to his art, original, varied, practically valuable, no one has deserved a higher place in the-history of American Medicine. Dr. Buck was noted for his sterling integrity, his high sense of professional honor, his consistent Christianity, his charity to the poor, and his quiet devotion to his family. He left five children, three sons and two daughters. His eldest son, the late Dr. Albert H. Buck, for many years a Professor in the College of Physicians and Surgeons, New 150 York, was a pioneer of modern otology in this country and one of the most distinguished specialists and writers of his time. The youngest son, the late Dr. Francis D. Buck, spent his life as a successful practitioner of general medicine in New York City. It was my great good fortune to have been somewhat closely associated with Dr. Buck during'the last years of his life, both in the Presbyterian Hospital and outside. With his family, especially his distinguished son, Dr. Albert H. Buck, I was particularly intimate. Both contributed substantially to my professional advancement. Dr. Buck was remarkable for the wide range of his surgical training and experience, great technical skill and extraordinary ingenuity and fertility of invention. While not a rapid operator his work showed wonderful perfection of execution. This was particularly evident in his plastic operations upon the face, in which the accurate coaptation and careful stitching of the severed parts were marvels of fine workmanship. Perfect surgical technique, painstaking personal attention to the after care of cases and thorough knowledge of general medicine with the wise application of its principles were the secrets of his success. Gurdon Buck, anatomist, surgeon, investigator, inventor, died at his home in New York City in March, 1877. 151 WILLIAM HOLME VAN BUREN WILLIAM HOLME VAN BUREN, M.D. WILLIAM HOLME VAN BUREN, M. D. Dr. William II. Van Buren was born in New York City in 1819. His parents were of Dutch descent, his great grandfather having studied under Boerhave in Leyden and emigrated to New York in 1700. Dr. Van Buren graduated from Yale in 1838. He attended medical lectures at the University of Pennsylvania, but before taking his degree there in 1840 went to Paris and studied under Velpeau. On his return he wrote a thesis on "The Use of Immovable Dressings in the Treatment of Fractures." His was the first attempt to introduce this practice and the thesis made a strong impression on the profession. The first five years of his graduate life were spent in the U. S. Army, chiefly as Assistant Surgeon under General Winfield Scott. He began practice in New York in 1845, acting as prosector for his distinguished father-in-law, Dr. Valentine Mott. Several years later he became Professor of Anatomy in the University of New York, holding the position for fourteen years. For sixteen years he was Professor of the Principles of Surgery in the Bellevue Hospital Medical College, lecturing also in Clinical Surgery, particularly with relation to the genito-urinary organs, and finally. becoming a specialist in their affections when a special chair was created for him in 1866 in Bellevue. He was Visiting Surgeon to St. Vincent's Hospital from its organization in 1849, and occupied a similar position in the New York Hospital from 1852 to 1868. He was Surgeon to Bellevue during his entire career. During the War of the Rebellion he took an active part in the organization of the U. S. Sanitary Commission, sparing neither time nor money. His contributions to medical literature were valuable. His treatise on genito-urinary disease, written in collaboration with his brilliant and distinguished associate, the late Dr. Edward Lawrence Keyes, being a well recognized classic. I am personally able to concur with Dr. Samuel D. Gross, when he said of Dr. Van Buren: "He was of lofty stature, well proportioned, gentle in his voice, bland and courtly in his manners and scrupulously neat in his dress. As a lecturer, he was clear, distinct and instructive." 155 In 1842 he married the eldest daughter of Dr. Valentine Mott of New York, the greatest surgeon of his generation. Dr. Van Buren died in 1883. My acquaintance with him was formed at the City Hospital where, as interne upon the service of Dr. Keyes, I was called upon to provide clinical material for Dr. Van Buren's very popular and largely attended lectures and to assist him in the amphitheatre. More than once when I had secured for him a case of interest and had prepared it for operation to his satisfaction, the Professor, with a pleasant introduction, would give place to me "to operate before the class," a courtesy toward a youthful interne as unusual as it was gracious. 156 WILLIAM LUDWIG DETMOLD WILLIAM LUDWIG DETMOLD, M.D. WILLIAM LUDWIG DETMOLD, M. D. Dr. Detmold was born in Hanover, Germany, in 1808. Graduating in Medicine at Gottingen in 1830, he served as an army surgeon until in 1837 he came to New York. Here, in 1841, he established an Orthopedic Clinic. At the opening of the Civil War he assisted in the organizing of the U. S. Army Corps, and in 1862 became Professor of Military Surgery and Hygiene in the College of Physicians and Surgeons, New York. This Professorship he held until 1865, when the title was changed to Professor of Clinical and Military Surgery. He was made Emeritus Professor in 1870. His book on the treatment of Club Foot and analogous subjects marked an advance in the progress of orthopedics. Dr. Detmold was a founder and the first President of the New York County Medical Association, and at one time President of the Society for the relief of Widows and Orphans of Medical Men. As a member of the Medical Board of the Presbyterian Hospital he offered a striking contrast to his associates. They, without exception, were native born, of the purest old American stock and training. He was typically a North German. The infusion of this foreign element was not without advantage, especially as Dr. Detmold's experience had been so different from that of the others. Wisely conservative, he was in some respects particularly liberal. Throughout the many years of its existence those admitted to intimate acquaintance with the Presbyterian Hospital have recognized the presence of a spirit of kindliness and of sympathetic interest by no means unusual in other American hospitals but here particularly evident. In the course of his practice in New York, Dr. Detmold, although a Gentile, had secured an important clientele among the best Hebrew element. The bearing of this upon the history of the Presbyterian Hospital is interesting. The kindness and attention customary in the treatment of all of its patients was extended to those of Dr. Detmold in like manner with the rest. An impressive contrast was thus offered them to the forbidding atmosphere of the typical hospital and the brusque attitude of its 159 attendants to which some of them had been accustomed in the countries of Central Europe whence they had come. The first to enter the hospital left it deeply touched and gratified, to become its lifelong friends. To this day they and those who have followed them have been its appreciative and its gracious benefactors. Dr. Detmold was particularly considerate toward the members of the house staff. He insisted that they should receive proper respect from patients and attendants and, \wThen justifiable, secured for them a modest but very welcome honorarium. To young men courageously struggling under almost superhuman difficulties to fit themselves for the always self-sacrificing medical career, such consideration, almost universally withheld, is worthy of thought. To myself the few small fees thus legitimately granted through the suggestion of my old friend were practically helpful and were the occasion of great encouragement. The regular salary I was then receiving from the hospital for work day and night, most responsible and arduous, although considered liberal and certainly very welcome, was small, and on leaving the Hospital I would be obliged to make an independent start. Dr. Detmold, recognizing this and other factors of the case, was kind accordingly. He died at his home in New York City in 1885. 160 ALFRED CHARLES POST ALFRIED CHARLES POST, M.D., LL.D. ALFRED CHARLES POST, M.D., LL.D. Dr. Post, born in New York City in 1806, was a son of Joel H. Post, a merchant, and Elizabeth Browne Post, his wife. 1-e was a nephew of Dr. Philip Wright Post, one of the most distinguished surgeons of his period, an early pupil of Sir John Hunter of London, and a man of whom is was said by Dr. Valentine Mott that "he was an unrivalled anatomist, a most beautiful dissector and one of the most luminous and perspicuous teachers I have ever listened to, either at home or abroad." He was a man of high character and a great surgeon. Dr. Alfred Post, the nephew, graduated from Columbia in 1822, and entered the College of Physicians and Surgeons under the preceptorship of his uncle, but owing to a severe illness did not graduate until 1827. Upon graduating he went abroad and spent two years studying in England, Paris, Berlin and Italy. In 1829 he returned home and became house surgeon in the New York Hospital, to which institution he was made visiting surgeon in 1836, holding the position until 1853. In 1851 he was appointed to the chair of surgery in the New York University, where his teaching became very popular. The field of his surgical operations covered a wide range, no performance being too great or too small for him. His professional activities were continued until he had attained the age of four score years. Married in 1831 to a daughter of Cyrenius Beers of New York he had eleven children, one of whom, Dr. George Edward Post, a medical missionary, scientist and author, graduated in medicine in New York in 1860 and spent a long and eminently useful life in Beyruit, Syria. Dr. Alfred Post was the physician of various members of my family for more than thirty-five years. During my residence at the hospital, although advanced in age, he was on active duty, operating frequently and spending much time in the wards. From infancy I had been given abundant opportunity to study him at close range. He was a man of rather small stature, quick in his movements and of nervous temperament. His memory was prodigious. He had stored it with a large fund of medical knowledge gained from extensive reading of the best authors, ancient as well as new. He was an accomplished 163 linguist and deeply versed in the literature and poetry of the languages known to him. Dante seemed to be as familiar to him as Shakespeare and so were the poets of France and Germany. Of general information, especially upon subjects related to science, his mind was a treasurehouse. He invented several instruments and suggested various surgical procedures. Few of them have survived. He was one of the very last to carry the old methods of surgery into the later period. 164 CHARLES K. BRIDDON CHARLES KELLY BRIDDON, M.D. CHARLES KELLY BRIDDON, M.D. Among those whose character and influence made a strong impression upon the growth of the Presbyterian Hospital was Dr. Charles K. Briddon. Dr. Briddon had come from England as a youth and by earnest effort had well prepared himself for the important positions which he later attained. He was a fine surgeon and physician, ingenious, discerning and wise, a remarkably careful operator and one who studied the welfare of his patients from every point of view. His results were excellent. With Dr. Lewis A. Stimson he was among the first to adopt the rules of antiseptic surgery. Toward the house officers he was always most considerate and instructive. Years after my time in the hospital, in his old age, no one ever claimed among those who had worked under him a larger group of loving and appreciative friends. In an account given by him in 1902 of some of the experiences of his early days he describes the rigorous discipline of his own professional training and says: "Now I must speak of the general practitioner in this city fifty years ago. If successful his position was no sinecure. The rank and file of the profession were at no time sure of obtaining a night of unbroken sleep. For the first twelve years after I was fairly engaged in practice I rarely passed a night without being summoned to some bedside. I was surgeon to the male attending department of the New York Dispensary from 1857 to 1865, an institution that averaged about 40,000 medical and surgical cases a year. I had made arrangements with the district physicians to attend personally all the surgical cases that could not or would not be sent to a hospital. I had my hands full. Operations of all kinds had to be done in tenement houses of the poorest kind. Many tracheotomies and hernieotomies were done at night, in rooms illuminated with tallow candles or in some more favored places with a kerosene lamp, with untrained assistance and with few or no antiseptic precautions. Often there were other dangers outside the locked doors, where were mutterings which were significant of the possibilities of personal violence in the event of an unsuccessful issue of the case. I have always regarded the period of my life during which I was on the staff of the New York Dis167 pensary as the most active and trying of my professional career. Besides the duties appertaining to that office I was engaged in active practice among the poor and was consulted in most of the emergencies in the lower wards of the city. It certainly was not lucrative, but the reward came in the consciousness that I had done my best." Dr. Briddon was appointed attending surgeon to the Presbyterian Hospital in 1876, and consulting surgeon in 1900. He died in office in 1916, thus completing a service of forty years, the longest thus far in the records of the Hospital. Years after I left the Hospital he became my near neighbor. He had been and always remained my loyal and deeply respected friend. The beauty of his spirit was reflected in his countenance. 168 LEWIS ATTERBURY STIMSON LEANIS ATTERBURY STIMSON, M.D., LLD. LEWIS ATTERBURY STIMSON, M.D., LL.D. Dr. Stimson, born at Paterson, New Jersey, in 1844, was the son of Henry C. Stimson and Julia Atterbury Stimson, his wife. The father's family came to this country from England in 1631. The Atterburys were also of English origin and came here at about the same date. Dr. Stimson's mother was of the Boudinot family, descendants of Huguenots who left France at the time of the revocation of the edict of Nantes. The four sons of Henry Stimson graduated from Yale College, Lewis in the class of 1863. He at once entered the Union Army, serving very actively as Captain and Aide-de-camp on the staff of General Terry until the end of the Civil War. For several years he engaged in business but decided to study medicine and went to Paris where he remained three years, returning home for a final year at Bellevue where he received his medical degree in 1874. He occupied the chair of physiology in the New York University Medical College from 1883 to 1885; that of Anatomy from 1885 to 1889, and of surgery from 1889 to 1898. Dr. Stimson was appointed attending surgeon to the Presbyterian Hospital in 1876. This position he held for thirteen years, resigning in 1889 to become surgeon to the New York Hospital and its downtown branch, the Chamber Street House of Relief. There he gained the experience in traumatic surgery which formed the basis of his book on fractures and dislocations. Both of these hospitals were served by him continuously for over thirty years, when he became a member of the consulting staff. He was also visiting surgeon to Bellevue. He was a member of the State Board of Regents from 1893 to 1904. In 1900 Yale University conferred upon him the degree of LL.D. Dr.. Stimson was largely influential in establishing the Medical Department of Cornell University, in 1898, and of securing the interest of wealthy friends to finance and support it. His personal efforts brought about the affiliation of the Cornell School with the New York Hospital in 1912. He was appointed professor of surgery at Cornell in 1898. Dr. Stimson was an active agent in the early introduction of antiseptic surgery and was a recognized authority on fractures. His works, written in classical English, showed unusual literary skill and judgment and profound knowl171 edge. He war the first to advocate the use of individual ligature to the four cardinal uterine vessels in hysterectomy for fibroid tumors, thus transforming a hazardous into a comparatively safe procedure. He was an eminently good teacher. Of fine presence and strong personality, he would have commanded success in any walk of life. His first attempt at professional writing, on "Bacteria and their influence upon the origin and development of septic complications in wounds", was awarded the James R. Wood prize in 1875. His great work, the treatise on "Fractures and Dislocations", which passed through eight editions, has been called a "classic of bibliographic thoroughness and scientific critique." His son, Hon. Henry L. Stimson, was Secretary of War in the Cabinet of President Taft. During the recent war Dr. Stimson made two visits to France on missions of relief for French war orphans and to visit military hospitals. Observations on the treatment there of compound fractures were incorporated in the last edition of his book. Always fond of outdoor sports, he died suddenly while walking near his home in Long Island September 17, 1917, accompanied by his lifelong friend and college companion, the late Dr. Edward L. Keyes. The career of Dr. Stimson was singularly varied, as were his accomplishments. In his youth the quietude of college life gave way to a military experience of exceptional sternness. Then several years of active business, followed by student life in Paris, the return to New York, entrance upon practice, marriage and early appointment to a highly responsible professional position. Dr. Stimson was appointed to the Presbyterian Hospital shortly before my incumbency as Resident. He had been most happily married for several years and had two young children, a son and a daughter. Soon after his appointment the death of Mrs. Stimson, his wife, brought to him the tragedy of his lifetime. Overwhelmed as he was he continued his visits to the wards of the hospital and under almost superhuman self-control carefully carried out the details of his routine. Mly daily intimate contact with him at that trying time gave clear insight into the strength and greatness of his character. He never married again. Dr. Stimson was an accomplished linguist and scholar. His writing showed extensive general reading together with literary ability of a high order. His chief recreation was yachting. Fond of sailing, he was one of the most skillful 172 and daring navigators and yachtsmen of his day. He possessed himself of a fine sea-going schooner rigged yacht, the "Fleur de Lys," in which he made extensive voyages, sometimes to the Mediterranean and other Southern waters, but more often to Northern latitudes, where year after year he visited Norway, Iceland, Greenland and the Labrador. His most famous exploit was the part taken in the great Ocean Race of 1905, for the "Kaiser's Cup." Eleven yachts were entered, the champions of the American, English and German fleets. The "Fleur de Lys" although considerably smaller than the rest arrived seventh on the list, only seven hours behind the third contestant, a wonderful record for a boat of its size, the winner being the American yacht, "Atlantic." Dr. Stimson finally presented the "Fleur de Lys" to Dr. Wilfred T. Grenfell, to aid in the work of the Grenfell Labrador mission. My early acquaintance with him, cemented by strong college as well as professional and social associations, was delightfully continued throughout his lifetime. 173 SAMUEL THOMAS HUBBARD SAMUEL THOMAS HUBBARD, M.D. SAMUEL THOMAS HUBBARD, M.D. Dr. Hubbard was born at Haddam, Connecticut, February 19, 1808. He was of the best English American stock and was educated at the Garfield Grammar School at Mid(lietowni, Connecticut. Determining to study medicine he entered the College of Physicians and Surgeons and received from it the Doctorate degree in 1835. He established himself in New York and succeeded in acquiring an extensive and valuable practice, making his home in West 9th Street. He was a man of great industry and while carrying on his practice with entire fidelity to the work busied himself in many outside professional interests. Thus he was a member of The Medical Journal Association, The Medico-Legal Association, The Society for the Relief of Widows and Orphans of Medical Men, The Physicians' Mutual Aid Association. An active member of the Academy of Medicine he had been its Corresponding Secretary from 1853 to 1858 and a Trustee from 1862 to 1873. In 1876 he was again elected a Trustee in recognition of his zealous endeavors in the promotion of the interests of the Academy. He was also a Vice-President of the Academy, a 'Trustee of the College of Physicians and Surgeons and one of the founders of the New York State and County Medical Associations. These executive duties were never allowed to interfere with the welfare of his patients, to whom he devoted himself with diligent attention. Personally he was possessed of a genial temperament and a keen sense of humor. With his excellent knowledge of medicine was combined a profound insight into human nature. These, ripened with a wide and well studied experience, made him the wise practitioner whose teachings and example in the wAards of the Hospital were so valuable to me. "Conservative, painstaking, and understanding medicine and its practice, he was a New Englander in his tastes and habits, dignified yet approachable, one of the last of his medical class." He died of laryngeal carcinoma at his home June 1, 1894, at the age of 84. 177 GEORGE ABSALOM PETERS JOHN JACOB CRANE GEORGE ABSALOM PETERS, A.M., M.D. GEORGE ABSALOM PETERS, A.M., M.D. Dr. Peters was born in Bennington, Vermont, May 12, 1821. He was the son of Absalom Peters and Harriet Hatch Peters and a grandson of General Absalom Peters, a graduate of Dartmouth College, in 1780. His father also graduated from Dartmouth and later from the Theological Seminary at Princeton. As a clergyman he filled many positions of importance and responsibility. Dr. Peters entered college but was obliged to leave through lack of funds. Later he came to New York, studied medicine and in 1846 was graduated, with honor, from the College of Physicians and Surgeons. He secured an interneship at the New York Hospital, completing his term of service in 1848. He soon attained a high position in New York, both in professional and social life. For many years he was one of the Attending Staff of St. Luke's Hospital. Later he was placed upon the Consulting Staff Boards of St. Luke's Hospital, the Woman's Hospital, the Presbyterian Hospital and others. He was a Trustee of the Academy of Medicine and of the College of Physicians and Surgeons, and a member of the Medical and Surgical Society, the New York Pathological Society and others. He was a member also of the Century Club, the Union League Club and the University Club. Of the University Club he was one of the original members and he enjoyed the distinction of being its President from 1888 until 1891. In 1849 he was married to Miss Julia Coggill, daughter of one of the well known old families of New York. Their daughter became the wife of Mr. Horace Hatch Chittenden. In 1851 Dr. Peters received the degree of M.A. from Williams College and in 1881 the same degree from Yale. He died at his home in New York City December 6, 1894. 181 JOHN JACOB CRANE, M.D. Dr. Crane was born in Middletown, Connecticut, in 1820. He prepared for college at Middletown and entering Princeton, College, graduated from it in the year 1840. He then came to New York City, matriculated at the College of Physicians and Surgeons and received the degree of Doctor of Medicine in 1844. Establishing himself in New York he soon acquired an excellent reputation as a surgeon and was appointed Attending Surgeon to Bellevue Hospital. This position he filled with distinction for more than twenty-five years. In 1867 he was elected to the position of Trustee of the College of Physicians and Surgeons. Upon retiring from practice he removed to New Haven, Connecticut, where he died: March 4th, 1890..My acquaintance with Dr. Crane was too slight to enable me to give any personal recollections of his character or life. I have been unable to find any published record of him or any pictures. This is unfortunate, for the fact that he was one of the men of distinction who formed the original Consulting Staff of the Presbyterian Hospital proves that he was possessed of exceptional professional ability, fine personal character and social standing of a high order. 182 THOMAS E. SATTERTHWAITE THOMAS E. SATTERTHWAITE, M.D., LL.D., Sc.D. THOMAS E. SATTERTHWAITE, M.D., LL.D., Sc.D. The first appointment to the department of pathology in the Presbyterian Hospital was that of Dr. Charles Stedman Bull, made in 1871. Dr. Bull served for two years, retiring in 1873 to devote himself to ophthalmology, in which department he became distinguished. He was followed by Dr. Satterthwaite, who served continously from 1873 until 1888, a period of fifteen years. The ancestry of Dr. Satterthwaite is interesting. H1-is name can be traced backward in Lancashire, England, for nearly four hundred years, while in this country his immediate forebears have married into such families as Sheafe, Wentworth, Fisher, Bache and Rutgers, highly representative of the best American stock. His grandfather came to New York City from England about 1790. His father, Thomas W. Satterthwaite, was born in New York City in 1797. His mother, Ann Fisher Sheafe, was of a family which "for upwards of five hundred years left a record notable for useful public service and private benevolence." Dr. Thomas E. Satterthwaite was born in New York March 26, 1843. He graduated from Yale College in 1864, taking at the same time a year's course in medicine. The following year, spent at Harvard, was devoted to a course in comparative anatomy under Prof. Jeffries Wyman and to his second year in medicine. He then entered the College of Physicians and Surgeons, New York, graduating in 1867. Completing an interneship in the surgical department of the New York Hospital in 1869, he spent a year in Vienna and at the outbreak of the Franco-Prussian war was appointed assistant contract surgeon in the German army, promoted to a full surgeoncy as captain and subsequently received the Iron Cross. Following this he devoted himself to the study of pathology and in 1872 returned to New York and entered upon practice. Since then his career has been one of wide and varied accomplishment as pioneer administrator, surgeon and writer. Dr. Satterthwaite has held many positions of importance. He has been president of the N. Y. Pathological Society, The Babies' Hospital, the American Therapeutic Society, and The Medical Association of Greater New York. He organized the Chambers Street House of Relief, of the 185 New York Hospital, originated the plans which led to the founding of the N. Y. Post Graduate Medical School and Hospital and was one of the incorporators of the Alumni Association of the College of Physicians and Surgeons. He was professor of pathological anatomy and later of general medicine at the Post Graduate Medical School. In 1873 he originated what was probably the first private laboratory in this country for instruction in normal and pathological histology, continuing this course for fi-fteen years. In his early professional life he was a clinical assistant to Prof. Willard Parker. He was at various times on the staffs of many New York hospitals, among them Pathologist of St. Luke's and the Presbyterian Hospital. He is now Consultant to the Manhattan State, the Post Graduate, the Babies' and the Orthopedic Hospitals and to the North Western Dispensary, and a trustee of the Good Samaritan Dispensary. He has made many contributions to medical literature, the most important being "A iManual of Histology" in 1882; a "Practical Bacteriology" in 1887; "Diseases of the Heart and Aorta," 1905; "Cardio-Vascular Diseases," 1902, and "Diseases of the Heart and Blood Vessels," 1918. As the outcome of his ability in the Departments of Histology, Pathology and Microscopy his aid was sought in medico-legal cases and in the investigation of diphtheria, at the instance of the Board of Health in its early days. He was also employed by the U. S. Department of Agriculture in its efforts to control sonme of the diseases of animals. This was prior to the founding of the Bureau of Animal Industry. Later he investigated pleuro-pneumonia in cattle, then prevalent-and hog chlolera. A number of other important cases marked this part of his career. Dr. Satterthwaite is a member of a large number of -medical and social associations. For many years he was on the staff of the "New York Medical Record" and at one time was on that of the "Medical News," at Philadelphia. He founded the "Journal of Comparative Medicine and Surgery" in 1880, and in 1885 "The Post Graduate," at first called "The Quarterly Bulletin." He has been the author of many medical articles and contributions to standard works. Dr. Satterthwaite was married in New York City November 13, 1884, to Miss Isabella,' daughter of Dr. James Lenox Banks and grand-niece of Mr. James Lenox. 186 THE FUTURE Thus, I have searched my memory in the effort to recount some of the conditions and events which marked the early days, the formative period, of the Presbyterian Hospital. With regard to them the hospital was in many respects distinctly in advance of its time. Its affairs were conducted by its managers with a liberality of purpose and of execution which before had been unknown. Every means was generously provided by them for the production of the best results. Its surgeons were largely men of the most advanced ideas, zealous in seeking out the new discoveries and earnestly subjecting them to practical tests. Their work, as that of the hospital in general, was of a high order of merit, far better than the average of the time. And this, it seems to me was the record of the hospital for the generation which followed mine. Wonderful things were happening then, things hard for those to appreciate who have not had a glimpse of the old regime. Great things are yet to come, things in which the Presbyterian Hospital will still lead. In the midst of the mighty transition from its original self to the unknown future which lies before it be it hoped that the leaders of its destiny may not be unmindful that what they now possess is the outcome of the tireless efforts of two generations of devoted men. Whatever scientific success may attend its progress, may the spirit of its founders ever remain the dominating influence which shall guide it forward upon its beneficent way, a leader in the education of coming generations, a brilliant center of research, but also a bearer of present help and comfort to the needy, a haven for the relief of the suf ferings of humanity, in the broadest and most philanthropic sense. 187 Yale University has just bestowed one of her most highly prized degrees, that of Doctor of Science, upon a member of the Staff of the Presbyterian Hospital-Alphonse Raymonde Dochez-in recognition of the great discoveries which he has contributed to medical science. What happier augury for the future of the institution could there be than this! 188 THE NEW HOSPITAL REFERENCES "An Account of Bellevue Hospital with a catalogue of the Medical and Surgical Staff from 1736 to 1894." By Robert G. Carlisle, M. D., New York, 1893. Published by the Society of the Alumni of Bellevue Hospital. A complete and authoritative account of the growth of the institution from its earliest beginnings as an Alms House. "Recollections of Mr. James Lenox, of New York, and the Formation of his Library." By Henry Stevens. Published by Henry Stevens & Son, London,1886. From the archives of the Lenox (now the New York Public Library) it would appear that no other original biography of Mr. James Lenox exists. The Stevens book has never been republished. Copies of it are rare. I have not hesitated to quote extensively from it. D. B. D. "Surgery in Bellevue Hospital Fifty Years Ago." By Henry Mann Silver, M. D. New York Medical Journal and Record, December 3, 1924. Dr. Silver gives a valuable presentation of the methods of Dr. James R. Wood and of the other leading surgeons of Bellevue during the period of his interneship in that institution, immediately prior to the introduction of antisepsis but far in advance of the time. "The Medicine of Seventy-Five Years Ago." Harlow Brooks, M. D. The Clifton Medical Bulletin, Clifton Springs, N. Y., March, 1926. Vol. XII, No. 1. In an address presented at the Anniversary of the founding of the Clifton Spring Sanitorium, Dr. Harlow Brooks eulogized Dr. Foster, the founder, and made favorable comment upon the methods and the characters of Dr. Foster and the best of his contemporaries as compared with those of today. "History of the New York Public Library, Astor, Lenox and Tilden Foundations." By Lyndenberg. New York, 1923, page 95. "Personal Reminiscenses of the New York Hospital, from 1856 to 1900." By Robert Fulton Weir, M. D., etc. General Bulletin, the Society of the New York Hospital. Vol. I, No. 10, June 14, 1917. An admirable description of nearly fifty years of the life and usefulness of this great institution. Dr. Weir refers to several who were intimately associated with the founding of the Presbyterian Hospital. A more extended history of the New York Hospital was given in 1921, in the address of its President, Mr. Edward W. Sheldon, on the occasion of the celebration of the 150th Anniversary of the granting of the Charter of the Hospital by King George III of England. "Some Personal Reminiscenses of Charity Hospital." D. Bryson Delavan, M. D. Annual Report, Charity Hospital, 1909. Published by the Alumni Association of the Hospital. "The Hospital Situation in Greater New York." By E. H. Lewinski-Corwin. G. P. Putnam's Sons, London and New York, 1924. 190 A presentation of the subject, comprehensive and authoritative, in which is stated the number and character of the hospitals and dispensaries at present in New York. Compared with the number existing at the time of the opening of the Presbyterian Hospital it illustrates the development of the past fifty years. "Recollections of a Happy Life." By Elizabeth Christophers Hobson, with an introduction by Louisa Lee Schuyler. G. P. Putnam's Sons, N. Y., 1916. In Chapter VI of this book is given an authoritative account of the founding of the Bellevue Training School for Nurses, May 1, 1873. Mrs. Hobson tells us that in January, 1872, a group of ladies who had worked with Miss Louisa Lee Schuyler during the Civil War was assembled by Miss Schuyler for the purpose of forming a Visiting Committee for Bellevue and other public hospitals of New York City. Later Miss Schuyler secured legislation which authorized the members of the State Charities Aid Association which was founded by her and of which this Visiting Committee formed a part, to visit all the State and County institutions of Public Charities in the State of New York, for the purpose of reporting their conditions and of bringing about reforms. Mrs. Hobson was appointed a member of the Visiting Committee to Bellevue. Her description of the conditions then existing in that institution would seem incredible to any but those who, like myself, were witnesses of them. As the outcome of the work of the Visiting Committee the Training School for Nurses was established. Mrs. Hobson's description of this event is a classic in the history of Amercan Medicine. 191 UNIVERSITY OF MICHIGAN 39015046962364 Taubman Medical Library Do Not Remove Or Mutilate Card DEMCO "t xf I ý11z--- 1-1-11 m -, --", ý;,ýX " TZHIA Zoo. M Q-W --amms"amN " ý Ai V"J.`,;0,Q, ýJ JIM no V 0--- all nag, Is AKINS' 1 0 RJR! 30 0 cum -4.1 N to, tofu, Q, "J, MO per 1 -1 1001 Van!, MW % ý"i n Y"i As's 7 4 A ivy 0, z 7J, 1 IT NUN, =N hmiss 11 ý.- - '' I,. Olin; lj ýý, ""', -,?, - JJ-- - - ý --!'. 1, [INIM r!fif 1-0 fig, Mani W. 154"S "W" HIM OWN Pop Rif "Ay -4 Man AMINO, It. 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